A chronic cough,wheezing cough, and shortness of breath are classic symptoms ofchronic obstructive pulmonary disease(COPD), though there are others. As the disease makes airways constrict, phlegm accumulates, breathing requires a lot of effort, and infections can occur. The nature of COPD is one of repeated bouts ofexacerbation, and your symptoms may vary with each episode.The disease is a progressive one. Recognizing the symptoms of COPD can help you get an early diagnosis, which is likely to improve your outcome. Symptoms of an exacerbation are more sudden, and if you have COPD, you need to be able to identify signs of worsening disease or a COPD exacerbation so you can safely manage your condition.© Verywell, 2018
A chronic cough,wheezing cough, and shortness of breath are classic symptoms ofchronic obstructive pulmonary disease(COPD), though there are others. As the disease makes airways constrict, phlegm accumulates, breathing requires a lot of effort, and infections can occur. The nature of COPD is one of repeated bouts ofexacerbation, and your symptoms may vary with each episode.
The disease is a progressive one. Recognizing the symptoms of COPD can help you get an early diagnosis, which is likely to improve your outcome. Symptoms of an exacerbation are more sudden, and if you have COPD, you need to be able to identify signs of worsening disease or a COPD exacerbation so you can safely manage your condition.
© Verywell, 2018
Frequent Symptoms
Noticeable COPD symptoms may not show up until the disease is advanced and you’ve already incurred lung damage.
Common symptoms in early COPD, should they occur, include shortness of breath, wheezing, cough, fatigue, phlegm production, and chronic respiratory infections, which can range from mild to very severe depending on the stage of the disease.
Shortness of Breath
Shortness of breath (dyspnea), the hallmark symptom of COPD, can often be the first symptom to appear.Shortness of breath due to medical conditions can be described in several ways, but many people with COPD describe dyspnea as feeling like gasping or labored breathing. The sensation is also often described as “air hunger.”
Initially, you may only experience dyspnea when you exert yourself. However, as the disease progresses, dyspnea may occur even while you’re resting. A tool known as the Modified Medical Research Council (mMRC)Dyspnea Scaleis often used to help quantify these otherwise subjective symptoms.
As a symptom, dyspnea is the most anxiety-producing, disabling feature of COPD.
Exercise Intolerance
You may be unable to tolerate exercise or moderately strenuous activities like climbing the stairs in your house. With advanced COPD, you might not even be able to walk from one room to another.
Healthy people generally need to breathe faster and deeper while exercising to get enough oxygen and energy. With COPD, air actually becomes trapped inside the lungs, a condition described ashyperinflation of the lungs. The disease prevents you from taking deep breaths when you exercise, so you can’t absorb enough oxygen to get the energy needed for physical exertion. You will notice that you have to sit down and rest.
Sputum (Phlegm) Production
A large amount of thick sputum is often associated with abacterial lung infection, which canexacerbate COPD symptoms. The color and consistency of sputum may change when a bacterial infection is present.
Effects of COPD on air tubes and alveoli.
Causes and Risk Factors of Increased Mucus Production
Chronic Cough
Achronic coughin COPD is one that is long-term and doesn’t seem to go away. Medically, it’s defined as a cough that lasts for a period of at least eight weeks.
A cough with COPD can be dry (non-productive) or produce mucus. With some types of COPD, such aschronic bronchitis, the cough occurs daily and is associated with mucus production. Initially, the cough may be intermittent, but as the disease progresses, it may be present every day.
A chronic cough is often theinitialsymptom of the disease, yet it’s one that gets overlooked because many people attribute it to smoking (“smoker’s cough”), allergies, or other environmental irritants.
Wheezing
Chest Tightness
Tightness in the chest may give you a feeling of pressure within the chest walls that makes automatic breathing difficult. Chest tightness may be present when there is an infection in your lungs and it may make deep breathing painful, causing respiration to be short and shallow.
Airflow Limitation and Your SymptomsLong-term exposure to airway irritants causes the airways to become swollen and inflamed, obstructing airflow to and from the lungs. This process, referred to as airflow limitation, gets progressively worse over time, especially if such exposure continues. Airflow limitation directly correlates with the decline in lung function (and related symptoms) seen in COPD.
Airflow Limitation and Your Symptoms
Long-term exposure to airway irritants causes the airways to become swollen and inflamed, obstructing airflow to and from the lungs. This process, referred to as airflow limitation, gets progressively worse over time, especially if such exposure continues. Airflow limitation directly correlates with the decline in lung function (and related symptoms) seen in COPD.
Chronic Respiratory Infections
Another common symptom of COPD is often having colds, the flu, and/or pneumonia. COPD makes you more susceptible to these illnesses because you’re unable to clear out your lungs sufficiently.
Fatigue
Fatigue-related to COPD is different than ordinary tiredness. This poorly understood and often underreported symptom of COPD is something that doesn’t respond well to a cup of coffee or even a good night’s sleep.
Overall, fatigue is three times more common in people with lung disease than in those without it. While dyspnea is the most worrisome symptom among those with COPD,fatiguecan be one of the most bothersome. But more than that, fatigue associated with COPD increases the risk of hospitalizations.
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Advanced-Case SymptomsThere are symptoms that may occur more often when your COPD is severe or you’re in the later stages of the disease.Weight Loss and Loss of AppetiteWhile weight gain is more of a problem in the early stages of COPD, since you’re likely to be less active, losing your appetite and weight loss are common problems in more advanced stages of the disease.Good nutrition is important for everyone, but it’s particularly essential when you have COPD. When not addressed, these symptoms can lead tomalnutrition, a serious condition that can also be life-threatening.Many pulmonologists recommend nutritional counseling for patients with COPD.Both appetite loss and unintentional weight loss are symptoms that warrant further investigation, as they may also indicate that other diseases are present, such aslung cancerorpulmonary tuberculosis.Muscle AtrophyCachexia is a condition that includes both weight loss and muscle wasting and is a significant cause of death in people with many chronic diseases, including COPD.SwellingYou may noticeswellingin your legs, ankles, and feet as the disease progresses or if your COPD is severe.
Advanced-Case Symptoms
There are symptoms that may occur more often when your COPD is severe or you’re in the later stages of the disease.
Weight Loss and Loss of Appetite
While weight gain is more of a problem in the early stages of COPD, since you’re likely to be less active, losing your appetite and weight loss are common problems in more advanced stages of the disease.
Good nutrition is important for everyone, but it’s particularly essential when you have COPD. When not addressed, these symptoms can lead tomalnutrition, a serious condition that can also be life-threatening.
Many pulmonologists recommend nutritional counseling for patients with COPD.
Both appetite loss and unintentional weight loss are symptoms that warrant further investigation, as they may also indicate that other diseases are present, such aslung cancerorpulmonary tuberculosis.
Muscle Atrophy
Cachexia is a condition that includes both weight loss and muscle wasting and is a significant cause of death in people with many chronic diseases, including COPD.
Swelling
You may noticeswellingin your legs, ankles, and feet as the disease progresses or if your COPD is severe.
In WomenOverall, women seem to be more susceptible to the side effects of smoking than men. In COPD, women are more likely to experience:More severe shortness of breathMore anxiety and depressionLower quality of lifeIncreased airway hyperresponsivenessWorse exercise performanceMore frequent exacerbations than menGreater risk ofmalnutritionGreater reduction in lung function at comparable levels of smoking than menThe effects of COPD are also more detrimental in women than they are in men. Once considered a “man’s disease,” since 2000,more women have diedfrom COPD each year than men.
In Women
Overall, women seem to be more susceptible to the side effects of smoking than men. In COPD, women are more likely to experience:
The effects of COPD are also more detrimental in women than they are in men. Once considered a “man’s disease,” since 2000,more women have diedfrom COPD each year than men.
ComplicationsManycomplicationscan occur as a result of COPD. Being aware of them can help you stay on top of your symptoms and get treatment as soon as possible if they occur.Recurring Respiratory InfectionsWhile chronic respiratory infections can tip you and your healthcare provider off to COPD, they can also further damage your lungs.It’s important to get your flu shot every year and to talk with your healthcare provider about getting the pneumococcal vaccine to help decrease the number of infections you pick up.Anxiety and DepressionThe emotional effects of COPD, especially anxiety and depression, are often overlooked. These symptoms are important not only due to their effect on your quality of life, but because they increase the risk ofCOPD exacerbationand a poorer health status overall.Panic attacks are also very common among people with COPD and can lead to a vicious cycle when combined with shortness of breath.Medicationsand other non-pharmacological treatments can help manage these concerns. Talk with your healthcare provider about treatment options.Heart DiseaseHaving COPD may increase your risk of heart disease and heart attack.Smoking can be a contributing factor to this, so quitting may help.Pulmonary HypertensionHigh blood pressure in the arteries in your lungs, called pulmonary hypertension, is a common complication of COPD, especially in the advanced stages of the disease.Symptoms of pulmonary hypertension can be similar to COPD. The condition is usually diagnosed via imaging and/or lab tests.Lung CancerCOPD is a strong independent risk factor for lung cancer, meaning that it raises your risk even if you have never smoked. And, of course, if you do light up, quitting can help lower the added risk of your habit.Respiratory FailureRespiratory failure can be a complication of COPD. It occurs when your lungs fail to do their job passing oxygen into your bloodstream and removing carbon dioxide.The first symptom of respiratory failure you might notice is shortness of breath—you’ll feel as if you just can’t take a deep breath or get enough air in your lungs. You may also start breathing rapidly.When your lungs don’t efficiently transfer oxygen and carbon dioxide, cells in your body start to suffer from a lack of oxygen (hypoxemia), too much carbon dioxide (hypercapnia), or both.This is why you can experience systemic symptoms of respiratory failure, such as:Feeling tired or fatiguedLethargy (you won’t have any energy)SleepinessA bluish tinge to your skinConfusionAs the disease progresses, efficiency of gas exchange in the lungs generally declines, leading toworsening symptoms, disability, and severe illness.Is Sinusitis Linked to COPD?
Complications
Manycomplicationscan occur as a result of COPD. Being aware of them can help you stay on top of your symptoms and get treatment as soon as possible if they occur.
Recurring Respiratory Infections
While chronic respiratory infections can tip you and your healthcare provider off to COPD, they can also further damage your lungs.
It’s important to get your flu shot every year and to talk with your healthcare provider about getting the pneumococcal vaccine to help decrease the number of infections you pick up.
Anxiety and Depression
The emotional effects of COPD, especially anxiety and depression, are often overlooked. These symptoms are important not only due to their effect on your quality of life, but because they increase the risk ofCOPD exacerbationand a poorer health status overall.
Panic attacks are also very common among people with COPD and can lead to a vicious cycle when combined with shortness of breath.
Medicationsand other non-pharmacological treatments can help manage these concerns. Talk with your healthcare provider about treatment options.
Heart Disease
Having COPD may increase your risk of heart disease and heart attack.Smoking can be a contributing factor to this, so quitting may help.
Pulmonary Hypertension
High blood pressure in the arteries in your lungs, called pulmonary hypertension, is a common complication of COPD, especially in the advanced stages of the disease.
Symptoms of pulmonary hypertension can be similar to COPD. The condition is usually diagnosed via imaging and/or lab tests.
Lung Cancer
COPD is a strong independent risk factor for lung cancer, meaning that it raises your risk even if you have never smoked. And, of course, if you do light up, quitting can help lower the added risk of your habit.
Respiratory Failure
Respiratory failure can be a complication of COPD. It occurs when your lungs fail to do their job passing oxygen into your bloodstream and removing carbon dioxide.
The first symptom of respiratory failure you might notice is shortness of breath—you’ll feel as if you just can’t take a deep breath or get enough air in your lungs. You may also start breathing rapidly.
When your lungs don’t efficiently transfer oxygen and carbon dioxide, cells in your body start to suffer from a lack of oxygen (hypoxemia), too much carbon dioxide (hypercapnia), or both.
This is why you can experience systemic symptoms of respiratory failure, such as:
As the disease progresses, efficiency of gas exchange in the lungs generally declines, leading toworsening symptoms, disability, and severe illness.
Is Sinusitis Linked to COPD?
When to See a Healthcare Provider/Go To the Hospital
Talk to your healthcare provider if you experience any of the above symptoms or complications, especially if they are chronic and/or you have risk factors for COPD. Symptoms of COPD may come and go and can overlap with those of other illness. In fact, you might think that you have a lingering infection or a “cold” that you can’t shake—but you need medical attention to know for sure and to begin any appropriate treatment.
If you already have COPD, know that your disease can progress and that exacerbations are the rule rather than the exception with this disease.
COPD Doctor Discussion GuideGet our printable guide for your next healthcare provider’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Signs of Worsening COPD
Call your healthcare provider if you develop:
When to Call 911Even if your COPD symptoms are well managed with medication, there is a risk of sudden respiratory distress or even death from the disease. This is a medical emergency.If you or your loved one have any of the following symptoms, seek immediate medical attention:Severe or sudden shortness of breathDifficulty speaking due to shortness of breathConfusion or forgetfulnessExtreme fatigue and decreased alertnessDifficulty waking from sleepChest painRapid heart rateBlue fingers or lipsCoughing up more than a teaspoon of blood
When to Call 911
Even if your COPD symptoms are well managed with medication, there is a risk of sudden respiratory distress or even death from the disease. This is a medical emergency.If you or your loved one have any of the following symptoms, seek immediate medical attention:Severe or sudden shortness of breathDifficulty speaking due to shortness of breathConfusion or forgetfulnessExtreme fatigue and decreased alertnessDifficulty waking from sleepChest painRapid heart rateBlue fingers or lipsCoughing up more than a teaspoon of blood
Even if your COPD symptoms are well managed with medication, there is a risk of sudden respiratory distress or even death from the disease. This is a medical emergency.
If you or your loved one have any of the following symptoms, seek immediate medical attention:
Create an Emergency Action Plan
It can be helpful to plan ahead for emergencies with COPD. Make sure you know how to call for emergency help. Be ready with your medical history and medication list so emergency healthcare providers will be aware of this when taking care of you.
Take time to talk withfamily members and loved oneswho are near you, so they are also aware of symptoms that should prompt them to call 911 if you can’t do it yourself.
A Word From Verywell
COPD symptoms can be a roller coaster ride of ups and downs. Preparing for those downward slopes while you’re riding smooth may not only decrease the impact of exacerbations but can also preserve your ability to pursue the activities you enjoy in your daily life.
Frequently Asked Questions
COPD is a degenerative disease that cannot be cured, but lifestyle changes and treatment may delay or improve symptoms. Quitting smoking is the mostimportant lifestyle changethat may improve or delay worsening symptoms. A nutritious diet will help give your body energy and some medications will help improve certain symptoms such as shortness of breath or inflammation.
Thefinal stages of COPDhave many similar symptoms as less advanced stages, but they are present all or almost all of the time. These include chronic cough, shortness of breath, wheezing, confusion, dizziness, fatigue, and difficulty sleeping or doing daily activities due to exacerbated symptoms.
There areoverlapping symptomsfor COPD and congestive heart failure such as shortness of breath and fatigue, but there are key symptoms that differ for each disease. Those that occur with COPD but not CHF include frequent respiratory infections. Those symptoms present for CHF but not COPD include heart palpitations, chest pain, and frequent nighttime urination. Cough can be a symptom for both CHF and COPD.
COPD Causes and Risk Factors
11 SourcesVerywell 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.NIH National Heart, Lung, and Blood Institute.COPD.InformedHealth.Chronic obstructive pulmonary disease (COPD).Miravitlles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respir Res. 2017;18(1):67. doi:10.1186/s12931-017-0548-3Sajadi SMA, Majidi A, Abdollahimajd F, Jalali F.Relationship between dyspnea descriptors and underlying causes of the symptom; a cross-sectional study.Emerg (Tehran). 2017;5(1):e62.Ramos FL, Krahnke JS, Kim V.Clinical issues of mucus accumulation in COPD.Int J Chron Obstruct Pulmon Dis. 2014;9:139–150. doi:10.2147/COPD.S38938Lesan A, Lamle AE.Short review on the diagnosis and treatment of bronchiectasis.Med Pharm Rep. 2019;92(2):111–116. doi:10.15386/cjmed-1060Moua T, Wood K.COPD and PE: a clinical dilemma.Int J Chron Obstruct Pulmon Dis. 2008;3(2):277–284.Yohannes AM, Alexopoulos GS.Depression and anxiety in patients with COPD.Eur Respir Rev. 2014;23(133):345–349. doi:10.1183/09059180.00007813Quint J.The relationship between COPD and cardiovascular disease.Tanaffos. 2017;16(Suppl 1):S16–S17.Sandelin M, Mindus S, Thuresson M, et al.Factors associated with lung cancer in COPD patients.Int J Chron Obstruct Pulmon Dis. 2018;13:1833–1839. doi:10.2147/COPD.S162484Cedars-Sinai.Chronic obstructive pulmonary disease (COPD).Additional ReadingHan MK, Dransfield MT, Martinez FJ.Chronic obstructive pulmonary disease: diagnosis, and staging.Mayo Clinic.COPD.Miravitilles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respiratory Research. 2017;18(1):67. doi:10.1186/s12931-017-0548-3
11 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.NIH National Heart, Lung, and Blood Institute.COPD.InformedHealth.Chronic obstructive pulmonary disease (COPD).Miravitlles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respir Res. 2017;18(1):67. doi:10.1186/s12931-017-0548-3Sajadi SMA, Majidi A, Abdollahimajd F, Jalali F.Relationship between dyspnea descriptors and underlying causes of the symptom; a cross-sectional study.Emerg (Tehran). 2017;5(1):e62.Ramos FL, Krahnke JS, Kim V.Clinical issues of mucus accumulation in COPD.Int J Chron Obstruct Pulmon Dis. 2014;9:139–150. doi:10.2147/COPD.S38938Lesan A, Lamle AE.Short review on the diagnosis and treatment of bronchiectasis.Med Pharm Rep. 2019;92(2):111–116. doi:10.15386/cjmed-1060Moua T, Wood K.COPD and PE: a clinical dilemma.Int J Chron Obstruct Pulmon Dis. 2008;3(2):277–284.Yohannes AM, Alexopoulos GS.Depression and anxiety in patients with COPD.Eur Respir Rev. 2014;23(133):345–349. doi:10.1183/09059180.00007813Quint J.The relationship between COPD and cardiovascular disease.Tanaffos. 2017;16(Suppl 1):S16–S17.Sandelin M, Mindus S, Thuresson M, et al.Factors associated with lung cancer in COPD patients.Int J Chron Obstruct Pulmon Dis. 2018;13:1833–1839. doi:10.2147/COPD.S162484Cedars-Sinai.Chronic obstructive pulmonary disease (COPD).Additional ReadingHan MK, Dransfield MT, Martinez FJ.Chronic obstructive pulmonary disease: diagnosis, and staging.Mayo Clinic.COPD.Miravitilles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respiratory Research. 2017;18(1):67. doi:10.1186/s12931-017-0548-3
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.
NIH National Heart, Lung, and Blood Institute.COPD.InformedHealth.Chronic obstructive pulmonary disease (COPD).Miravitlles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respir Res. 2017;18(1):67. doi:10.1186/s12931-017-0548-3Sajadi SMA, Majidi A, Abdollahimajd F, Jalali F.Relationship between dyspnea descriptors and underlying causes of the symptom; a cross-sectional study.Emerg (Tehran). 2017;5(1):e62.Ramos FL, Krahnke JS, Kim V.Clinical issues of mucus accumulation in COPD.Int J Chron Obstruct Pulmon Dis. 2014;9:139–150. doi:10.2147/COPD.S38938Lesan A, Lamle AE.Short review on the diagnosis and treatment of bronchiectasis.Med Pharm Rep. 2019;92(2):111–116. doi:10.15386/cjmed-1060Moua T, Wood K.COPD and PE: a clinical dilemma.Int J Chron Obstruct Pulmon Dis. 2008;3(2):277–284.Yohannes AM, Alexopoulos GS.Depression and anxiety in patients with COPD.Eur Respir Rev. 2014;23(133):345–349. doi:10.1183/09059180.00007813Quint J.The relationship between COPD and cardiovascular disease.Tanaffos. 2017;16(Suppl 1):S16–S17.Sandelin M, Mindus S, Thuresson M, et al.Factors associated with lung cancer in COPD patients.Int J Chron Obstruct Pulmon Dis. 2018;13:1833–1839. doi:10.2147/COPD.S162484Cedars-Sinai.Chronic obstructive pulmonary disease (COPD).
NIH National Heart, Lung, and Blood Institute.COPD.
InformedHealth.Chronic obstructive pulmonary disease (COPD).
Miravitlles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respir Res. 2017;18(1):67. doi:10.1186/s12931-017-0548-3
Sajadi SMA, Majidi A, Abdollahimajd F, Jalali F.Relationship between dyspnea descriptors and underlying causes of the symptom; a cross-sectional study.Emerg (Tehran). 2017;5(1):e62.
Ramos FL, Krahnke JS, Kim V.Clinical issues of mucus accumulation in COPD.Int J Chron Obstruct Pulmon Dis. 2014;9:139–150. doi:10.2147/COPD.S38938
Lesan A, Lamle AE.Short review on the diagnosis and treatment of bronchiectasis.Med Pharm Rep. 2019;92(2):111–116. doi:10.15386/cjmed-1060
Moua T, Wood K.COPD and PE: a clinical dilemma.Int J Chron Obstruct Pulmon Dis. 2008;3(2):277–284.
Yohannes AM, Alexopoulos GS.Depression and anxiety in patients with COPD.Eur Respir Rev. 2014;23(133):345–349. doi:10.1183/09059180.00007813
Quint J.The relationship between COPD and cardiovascular disease.Tanaffos. 2017;16(Suppl 1):S16–S17.
Sandelin M, Mindus S, Thuresson M, et al.Factors associated with lung cancer in COPD patients.Int J Chron Obstruct Pulmon Dis. 2018;13:1833–1839. doi:10.2147/COPD.S162484
Cedars-Sinai.Chronic obstructive pulmonary disease (COPD).
Han MK, Dransfield MT, Martinez FJ.Chronic obstructive pulmonary disease: diagnosis, and staging.Mayo Clinic.COPD.Miravitilles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respiratory Research. 2017;18(1):67. doi:10.1186/s12931-017-0548-3
Han MK, Dransfield MT, Martinez FJ.Chronic obstructive pulmonary disease: diagnosis, and staging.
Mayo Clinic.COPD.
Miravitilles M, Ribera A.Understanding the impact of symptoms on the burden of COPD.Respiratory Research. 2017;18(1):67. doi:10.1186/s12931-017-0548-3
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