Table of ContentsView AllTable of ContentsAcute vs. Chronic BronchitisAcute Bronchitis ComplicationsChronic Bronchitis Complications
Table of ContentsView All
View All
Table of Contents
Acute vs. Chronic Bronchitis
Acute Bronchitis Complications
Chronic Bronchitis Complications
Learn about the potential complications associated with both acute and chronic bronchitis.
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Bronchitis: An Overview
Before discussing the complications of bronchitis, it’s important to distinguish the two different kinds, as both the symptoms and impact can vary significantly.
Bronchitis: Causes and Risk Factors
While acute bronchitis usually runs its course, complications such as secondary bacterial infection (“superinfection”) may occur in 5% to 10% of people.
Can Acute Bronchitis Become Chronic Bronchitis?It’s important to note that, in addition to these complications, repeated episodes of acute bronchitis (especially in people who smoke or who are exposed to dust at work) can eventually lead to chronic bronchitis.This progression from acute bronchitis to chronic bronchitis is an important reason to talk to your healthcare provider if you are experiencing repeated symptoms and to eliminate potential causes, such as smoking.
Can Acute Bronchitis Become Chronic Bronchitis?
It’s important to note that, in addition to these complications, repeated episodes of acute bronchitis (especially in people who smoke or who are exposed to dust at work) can eventually lead to chronic bronchitis.This progression from acute bronchitis to chronic bronchitis is an important reason to talk to your healthcare provider if you are experiencing repeated symptoms and to eliminate potential causes, such as smoking.
It’s important to note that, in addition to these complications, repeated episodes of acute bronchitis (especially in people who smoke or who are exposed to dust at work) can eventually lead to chronic bronchitis.
This progression from acute bronchitis to chronic bronchitis is an important reason to talk to your healthcare provider if you are experiencing repeated symptoms and to eliminate potential causes, such as smoking.
Secondary Infections
Secondary bacterial infections or “superinfections” are not uncommon following an episode of acute viral bronchitis and can both lengthen and worsen the illness.
Viral infections affect the body in a few ways that predispose to these infections:
Bacteria that are commonly responsible for superinfections (and are often present on the skin and in the environment) includeStreptococcus pneumoniae(the bacteria that causes pneumococcal pneumonia),Haemophilis Influenzae,andStaphylococcus aureus.
Some potential secondary infections include:
Pneumonia
Pneumoniais the most common complication of viral acute bronchitis, occurring in roughly 5% of people. Among children aged 5 and over, as well as adults, the most common cause isStreptococcus pneumonia.
This is the reason why thepneumonia vaccineis recommended for children and for adults over the age of 65, as well as for people with lung conditions—such as COPD or asthma—or who are immunosuppressed for some reason.
In children under the age of 5, the most common cause of pneumonia isrespiratory syncytial virus (RSV), which may be responsible for initial bronchitis as well as a secondary viral infection.
Can Bronchitis Turn Into Pneumonia? Yes, Here’s How
Unlike acute bronchitis, complications are fairly common with chronic bronchitis, especially worsening of the condition (acute exacerbations).
Knowing Your Baseline With Chronic BronchitisFor people living with chronic bronchitis, it’s very important to know your “baseline,” or how you usually feel, as the symptoms that might suggest a complication (e.g., shortness of breath) may already be present to some degree.
Knowing Your Baseline With Chronic Bronchitis
For people living with chronic bronchitis, it’s very important to know your “baseline,” or how you usually feel, as the symptoms that might suggest a complication (e.g., shortness of breath) may already be present to some degree.
To objectively measure symptoms, some people use numbers to guide them. For example, if on a scale of 1 to 10 (with 1 being barely a problem and 10 being severe), a change from a 3 in your level of shortness of breath to a 5 could be a problem.
Daily home spirometry is another way to know if your lung function worsens. The most important point, however, is to know and listen to your own body. If you feel concerned about your health for any reason, talk to your practitioner.
Healthcare providers often use theBODE Indexto assess severity in people with COPD, such as chronic bronchitis. In addition to measuring the degree of shortness of breath, the index includes measures of exercise tolerance, airway obstruction (FEV1), andbody mass index(weight) to assess both the severity and potential worsening of the condition.
Dyspnea
Dyspnea, the medical term that refers to the sensation of shortness of breath, is common with chronic bronchitis. Not only can dyspnea be uncomfortable and cause significant anxiety, but it has been found to greatly interfere with the overall quality of life. That said, appropriate management can be very helpful,
Managing dyspnea requires a combination of several approaches:
Acute Exacerbation
Acuteexacerbationsof chronic bronchitis are common, yet of concern, in that they can be both uncomfortable (and sometimes dangerous) and may hasten the progression of the disease.
While there are a number of factors that can result in an exacerbation of chronic bronchitis, viral infections—such as acute viral bronchitis superimposed on chronic bronchitis—are a very common cause.
Symptoms of an acute exacerbation may include:
Depending on the severity of an exacerbation, hospitalization may be required. If a bacterial infection is responsible for the exacerbation (such as pneumonia), antibiotics will be needed. For people who have more than one exacerbation each year, inhaled corticosteroids are usually recommended.
Respiratory Failure
Respiratory failureis, unfortunately, a complication of chronic bronchitis. It occurs when the lungs fail to bring in enough oxygen to supply the tissues of the body (hypoxia). Without enough oxygen available, a number of bodily systems experience damage. It can also result in the buildup of carbon dioxide in the bloodstream.
A number of symptoms may suggest that respiratory failure is occurring, though the symptoms often vary depending on whether respiratory failure has come on slowly or rapidly.
With the sudden onset of severe respiratory failure, a person may develop severecyanosis(a bluish tinge to the fingers and lips) or become unconscious.
More commonly, respiratory failure begins more gradually. Symptoms may include:
When respiratory failure develops very slowly, symptoms may include primarily severe fatigue, apathy, and a disinterest in activities that would normally be of interest.
Respiratory failure is a medical emergency, especially if it develops rapidly. Treatment usually requires a number of medications (including those that dilate the airways, corticosteroids, etc.) as well as breathing support. This may include oxygen, non-invasive ventilatory support, or mechanical ventilation when severe.
Cor Pulmonale
Cor pulmonale orright-sided heart failure, can occur with long-term chronic bronchitis.
The left side of the heart has to be strong and thick to pump blood throughout the body. In contrast, the right side of the heart (right atrium and right ventricle) are thinner, as they only need to pump deoxygenated blood to the lungs (via the pulmonary artery, the only artery in the body that carries deoxygenated blood).
Symptoms of cor pulmonale are similar to those of left-side heart failure, which is most common but is often more severe. These may include:
Cor pulmonale can rapidly become life threatening and is a medical emergency. Treatment includes medications to reduce pressure in the pulmonary arteries, management of the underlying lung disease, diuretics (for fluid retention), blood thinners, and oxygen.
When very severe, and the above treatments cannot successfully manage the condition, a ventricular assist device to help the heartbeat may be needed.
Pneumothorax
Apneumothorax, or “collapsed lung,” is another potential complication of chronic bronchitis, especially in those who also have emphysematous changes in their lungs. With a pneumothorax, a “hole” in the lungs allows air to leak into the space (pleural cavity) between the two pleural membranes (pleura) that surround the lungs.
A pneumothorax can either be primary, occurring in a person with no underlying lung disease, or secondary, when underlying lung disease is present. In this case, a pneumothorax would be considered secondary due to chronic bronchitis/COPD.
Symptoms of a pneumothorax can vary from very mild to life threatening and may include:
It’s important to note that when non-life-threatening, symptoms of a pneumothorax often improve (and sometimes resolve) over the next 24 hours. For this reason, it’s important for people to contact their healthcare provider even if their symptoms appear to be improving.
Polycythemia
Polycythemia refers to a high red blood cell count and can have many causes. It is further divided into primary polycythemia andsecondary polycythemia, with secondary polycythemia occurring as a compensatory process related to another medical condition.
Symptoms of polycythemia are related primarily to the increased thickness (viscosity) of the blood. This increased viscosity may result in decreased blood flow to the brain (when the red blood cell count is very high) or in the formation of blood clots (thromboses).
Symptoms may include:
Reactive Airway Disease
Emphysema and COPD
Both chronic bronchitis andemphysemaare types of COPD, and since they have similar risk factors (such as smoking, exposure to airway irritants, etc.), they often occur together. Overall, roughly half of people diagnosed with COPD have bronchitis and half emphysema, with a much smaller number having bronchiectasis.
Emphysema is not necessarily a complication of chronic bronchitis, but needs to be considered with any of the complications discussed above as well as with the management of the disease, as potential treatments may vary. Fortunately, actions to prevent the worsening of both (avoiding smoking, fume exposure, viral infections, etc.) can reduce complications and worsening of both conditions.
Hemoptysis
Hemoptysis, orcoughing up blood, may occur with acute bronchitis and chronic bronchitis, or it could signal another condition altogether. When talking about coughing up blood, most people note only a tinge of blood on a tissue—an amount so small that you may question whether or not it is really blood. But coughing up even a small amount of blood, say a teaspoon, is a medical emergency.
If you’ve coughed up blood, see your healthcare provider right away, even if you feel there is an obvious cause (such as throat irritation). In many cases, treatment of the underlying problem will resolve the hemoptysis. When severe, however, treatments such as bronchial artery embolization can quickly stop a bleed that could otherwise have a poor outcome.
Summary
Whilebronchitismost often resolves on its own, in some cases it can lead to further complications.
A Word From Verywell
It can be frightening to hear about all of the potential complications that may accompany a diagnosis of acute bronchitis, yet being aware of these possibilities may help you catch a secondary condition before it can take hold.
Fortunately, there are ways to reduce complications whether you are dealing with acute or chronic lung symptoms. If you smoke, quit. Avoid any other triggers that may worsen your symptoms. And perhaps most importantly, listen to your body.
If something feels not just abnormal, but different for you, talk to your healthcare provider. Our bodies are pretty good at letting us know when there is a problem…if we only listen.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Kinkade S, Long NA.Acute bronchitis.Am Fam Physician.2016;94(7):560-565.
Morris DE, Cleary DW, Clarke SC.Secondary bacterial infections associated with influenza pandemics.Front Microbiol.2017;8:1041. doi:10.3389/fmicb.2017.01041
Nowicki J, Murray MT.Bronchitis and pneumonia. In:Textbook of Natural Medicine. Elsevier; 2020:1196-1201.e1. doi10.1016/B978-0-323-43044-9.00155-2
Miravitlies M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respir Res. 2017. doi:10.1186/s12931-017-0548-3
Hewitt R, Farne H, Ritchie A, et al.The role of viral infections in exacerbation of chronic obstructive pulmonary disease and asthma.Ther Adv Respir Dis.2016;10(2):158-174. doi:10.1177/1753465815618113
Bickler PE, Feiner JR, Lipnick MS, Batchelder P, Macleod DB, Severinghaus JW.Effects of acute, profound hypoxia on healthy humans: implications for safety of tests evaluating pulse oximetry or tissue oximetry performance.Anesth Analg. 2017;124(1):146-153. doi:10.1213/ANE.0000000000001421
Scala R, Heunks L.Highlights in acute respiratory failure.Eur Respir Rev. 2018;27(147):180008. doi:10.1183/16000617.0008-2018
Sakao S.Chronic obstructive pulmonary disease and the early stage of cor pulmonale: a perspective in treatment with pulmonary arterial hypertension-approved drugs.Respir Investig. 2019;57(4):325-329. doi.10.1016/j.resinv.2019.03.013
Arrigo M, Huber LC, Winnik S, et al.Right ventricular failure: pathophysiology, diagnosis and treatment.Card Fail Rev. 2019;5(3):140-146. doi:10.15420/cfr.2019.15.2
Imran JB, Eastman AL.Pneumothorax.JAMA.2017;318(10):974. doi:10.1001/jama.2017.10476
Corlateanu A, Mendez Y, Wang Y, et al.Chronic obstructive pulmonary disease and phenotypes: a state-of-the-art.Pulmonology. 2020;26(2):95-100. doi:10.1016/j.pulmoe.2019.10.006
Earwood JS, Thompson TD.Hemoptysis: evaluation and management.Am Fam Physician.2015;91(4):243-249.
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