What is the most common early symptom of COPD?

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that makes it difficult to breathe. The most common early symptom of COPD is shortness of breath, also called dyspnea.

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What causes COPD?

COPD is most often caused by long-term exposure to lung irritants that damage the lungs and airways. The most common irritant is cigarette smoke, which accounts for as many as 9 out of 10 COPD cases. Other irritants include secondhand smoke, air pollution, chemical fumes, and dust.

In COPD, less air flows in and out of the airways because of one or more problems:

The airways and air sacs lose their elastic quality.
The walls between many of the air sacs are destroyed.
The walls of the airways become thick and inflamed.

The airways make more mucus than usual, which can further block airflow.

What are the signs and symptoms of COPD?

The most common signs and symptoms of COPD include:

Shortness of breath (dyspnea), especially during physical activities: This is often the first symptom you’ll notice. At first, you may notice dyspnea during exercise or strenuous activity. But over time, you may start feeling short of breath even when resting. Your breathing may become very rapid and shallow. Shortness of breath tends to worsen over time, particularly if smoking exposure continues.

Wheezing: A high-pitched whistling sound produced when you breathe.
Chest tightness: Feeling like your chest is restricted and you cannot breathe deeply.
Chronic cough: A cough that lasts a long time, often accompanies increased mucus production.

Frequent respiratory infections: People with COPD are more prone to colds, the flu and pneumonia.
Lack of energy: A result of the restricted oxygen flow associated with COPD.
Unintended weight loss (in later stages): Again, due to the oxygen restriction and extra energy expended while breathing.

As COPD progresses, severe shortness of breath may limit your ability to do even simple activities. Chest discomfort and tightness may add to breathing difficulties.

Gas exchange problems due to COPD can eventually lead to high blood pressure in lung arteries (pulmonary hypertension), heart problems and other complications.

What are the risk factors for COPD?

The main risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke per day, the greater your risk of developing COPD.

However, some people develop COPD without smoking – or without smoking heavily. Factors that may increase the risk of COPD in nonsmokers include:

Secondhand smoke. Nonsmokers exposed to tobacco smoke at home or at work are at increased risk of developing COPD.
Air pollution. Long-term exposure to other lung irritants, such as air pollution, chemical fumes and dust, also may contribute to COPD risk, especially if you have a genetic risk factor.

A family history of COPD. People with parents who have COPD are more likely to develop the disease themselves, particularly if they smoke.
Being older than 40 years.
Being male. More men get COPD than women.

Having had childhood respiratory infections. COPD is more common in people who had frequent, severe respiratory infections as children.
Having a deficiency of alpha-1 antitrypsin (AAt). An estimated 100,000 Americans with COPD have this genetic disorder where a protein made in the liver is abnormal and doesn’t protect the lungs.

How is COPD diagnosed?

COPD is often misdiagnosed – many people don’t realize they have it. If you experience shortness of breath and have a history of exposure to lung irritants, talk to your doctor.

To diagnose COPD and determine the severity of the disease, your doctor may:

Ask about your symptoms and check your breathing.
Ask about your medical and family history.

Have you do breathing tests, also called pulmonary function tests or spirometry. You blow into a tube connected to a spirometer machine.
Measure your blood oxygen level. You may have blood drawn from an artery or wear a device called a pulse oximeter that estimates how much oxygen your blood is carrying (your oxygen saturation percentage).
Do a chest X-ray or computerized tomography (CT) scan to see if you have emphysema or other lung problems.

Based on your test results, your doctor can tell you whether you have COPD and how severe it is. Severity is divided into four stages:

Mild (stage I): Few symptoms, mild airflow limitation
Moderate (stage II): Worsening airflow limitation, shortness of breath when active

Severe (stage III): Greater shortness of breath, reduced lung function
Very severe (stage IV): Significant symptoms at rest or with little activity, risk of heart problems

What treatments are available for COPD?

Although damage to the lungs cannot be reversed, treatment can help control symptoms. Quitting smoking is essential.

Other COPD treatments may include:

Inhalers: Bronchodilators can open narrowed airways and decrease lung inflammation. These are often the first medicines used for COPD symptoms. Types used for COPD include anticholinergics, beta-agonists, combination inhalers, and steroids.
Pulmonary rehabilitation: A program of exercise training and disease management education helps improve breathing muscle function and quality of life.

Supplemental oxygen: For people with low levels of oxygen in their blood.
Surgery or procedures: Options range from minimally invasive procedures such as placing one-way valves into damaged lung areas to major surgery like lung volume reduction, which removes damaged lung tissue.
Lifestyle changes: Proper nutrition and rest, managing stress, practicing breathing control, staying active.

Monitoring for complications: More frequent doctor visits to monitor for things like respiratory infections or heart problems associated with COPD.

Treatment is tailored to each person’s COPD type, severity, symptoms, and health history. A combination of the above approaches is often used. The goals are to relieve current symptoms and prevent the lung damage from worsening.

What is the life expectancy for people with COPD?

COPD is a major cause of disability and death worldwide. The outlook depends largely on when the disease is diagnosed and how severe it is.

With mild COPD, you may not have symptoms that interfere with your daily life. Moderate to very severe COPD can significantly impair your quality of life and lead to life-threatening complications.

Overall COPD life expectancy is lower than for people without COPD. On average:

People with mild COPD lose about 1 year of life expectancy compared to people without COPD.

People with moderate COPD lose about 5 years.
People with severe COPD lose about 8 years.

But keep in mind that many people with COPD live much longer, especially if they take steps to manage their health. Quitting smoking, following your treatment plan, and practicing healthy habits can slow the progression of COPD and help you stay active.

Can COPD be prevented?

The best way to prevent COPD is to never start smoking cigarettes or stop smoking as soon as possible. Avoiding secondhand smoke and air pollution can also lower your risk.

If you have mild COPD, taking action may help prevent it from getting worse. Steps you can take include:

Quit smoking and avoid secondhand smoke and lung irritants.

Follow your COPD treatment plan.
Get recommended vaccines, including an annual flu shot.
Maintain a healthy weight.

Eat a balanced, nutritious diet.
Exercise regularly.
Manage stress and anxiety.

Limit alcohol use.
Practice good hygiene to avoid infections.

What’s the outlook for people with COPD?

While COPD itself cannot be cured, the right treatment can help slow the disease, relieve symptoms, and prevent complications. This allows many people with COPD to remain active.

New medicines and therapies continue to be developed and have improved outlooks. Quitting smoking, following your treatment regimen, and managing your health are key to living better with COPD.

Conclusion

In summary, the most common early symptom of COPD is shortness of breath. This is often the first noticeable sign, starting when you exert yourself and progressing over time even at rest. Other symptoms like wheezing, chest tightness, and chronic cough may gradually appear as COPD develops.

COPD is most often caused by long-term cigarette smoking and can be diagnosed using lung function tests. While lung damage cannot be reversed, available treatments help manage symptoms and complications. The earlier COPD is caught, the more can be done to help maintain quality of life. Quitting smoking is the essential first step.

Preventing COPD in the first place is ideal. Avoiding smoking initiation, secondhand smoke exposure, and practicing healthy habits offer the best protection against developing this progressive respiratory disease.