Causes and symptoms
COPD occurs as a result of damage to the lungs, in most cases (approximately 80% to 90%), through smoking. COPD risk increases with frequency and duration of smoking. 2
Other, much less common causes of COPD include passive smoking, genetic background and exposure to pollution. 2
The symptoms of COPD vary in intensity, from mild to severe, depending upon the stage of progression of the disease. Typical symptoms commonly seen in COPD patients include:
• Early morning 'smoker's cough', or persistent or chronic coughing.
• One of the most common symptoms of COPD, chronic cough results from the inflammation and damage caused to the lung tissue.
• Tight chest/ difficulty breathing/ shortness of breath (dyspnoea).
• Many COPD patients will complain of a tight chest which means they notice the effort to breathe regularly. Chest tightness makes deep breathing painful and causes short and shallow respiration.
• Mucus and phlegm (thicker mucus).
• Excessive sputum production is typically seen in COPD.
• Wheezing.
• The physical damage to the lung surface results in narrowed and less flexible airways. This produces wheezing during inhalation or exhalation, often so loud it may be heard without a stethoscope.
• Recurring lung and chest infections.
• As the lungs fail to clear debris and sputum properly, COPD patients are more susceptible to infection.
Other, less common symptoms of COPD include haemoptysis, cyanosis and clubbing of the fingers. 1, 5
Not all patients will present with all symptoms, and many symptoms overlap with other breathing disorders such as asthma.
COPD symptoms often worsen in the winter, and COPD patients may experience frequent exacerbations during the year. Exacerbation rates may vary, depending on many factors including the stage of their COPD and their adherence to treatment. COPD can affect work, hobbies, exercise and socialising, as well as impacting on relationships because of tiredness, breathing difficulties and a decline in physical capacity. People with COPD experience increased levels of anxiety due to the breathlessness, which long-term can also lead to depression. 1, 5
References
1. NHS Clinical Knowledge Summaries: Chronic Obstructive Pulmonary Disease. Available at https://www.cks.library.nhs.uk/patient_information_leaflet/chronic_obstructive_pulmonary_disease [Accessed August 2009]
2. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. Available at http://www.goldcopd.com/Guidelineitem.asp?l1=2&l2=1&intId=2003 [Accessed August 2009
5. van Wetering CR et al. Am J Respir Crit Care Med 2009;179:A5373