COPD: Chronic Cough, Wheezing, Shortness of Breath and When to Be Seen

What it involves

MedlinePlus explains that COPD, or chronic obstructive pulmonary disease, is a group of lung diseases that make it hard to breathe and get worse over time. It includes emphysema, which damages the air sacs, and chronic bronchitis, in which the airway lining is constantly irritated and inflamed.

Who this is for

• Patients who smoke or used to smoke and have a cough that persists
• Patients with wheezing or a tight chest, especially with activity
• Patients who get frequent chest colds or have been told they have asthma and still struggle
• Patients exposed to dust, fumes, or secondhand smoke at work or at home

What to expect

• Questions about your cough, mucus, breathing, smoking history, and exposure to fumes or dust
• A listen to the lungs and a review of your breathing and other vital signs
• A plan for further testing, which MedlinePlus says may include lung function tests and a chest x-ray or CT scan
• Advice on quitting smoking, vaccines, and what to do when symptoms flare

What COPD does to the lungs

MedlinePlus says that in COPD less air flows in and out because the airways and air sacs lose their stretch, the walls between air sacs are destroyed, the airway walls thicken and become inflamed, or the airways make more mucus than usual and clog. Most people with COPD have both emphysema and chronic bronchitis, in different degrees. The disease gets worse over time, which makes noticing it early worthwhile.

The symptoms to know

At first there may be no symptoms or only mild ones, per MedlinePlus. As COPD progresses it lists frequent coughing or a cough that produces a lot of mucus, wheezing or a whistling sound when breathing, shortness of breath especially with activity, chest tightness, and fatigue. People with COPD may get frequent colds and flu, and in severe cases swelling in the ankles, feet, and legs. Related guides include shortness of breath, persistent cough, and asthma symptoms.

Causes and risk factors

MedlinePlus says the cause is usually long-term exposure to irritants that damage the lungs, and in the United States cigarette smoke is the main one. Pipe and cigar smoke, secondhand smoke, air pollution, and chemical fumes or dusts at work can contribute. Up to 75 percent of people with COPD smoke or used to smoke, most are at least 40 when symptoms begin, and a rare genetic condition called alpha-1 antitrypsin deficiency can play a role. The quitting smoking guide describes how to stop.

How COPD is diagnosed

A provider asks about your symptoms, family history, and any smoking or exposure to lung irritants. MedlinePlus says tests may include lung function tests, a chest x-ray or CT scan, and blood tests. Those tests are typically ordered by a provider and done at a facility with the right equipment. Other causes of a lingering cough are covered in the acute bronchitis guide, which describes the short-term version.

Treatment and daily management

MedlinePlus says there is no cure, but treatment can help with symptoms, slow the disease, and keep you active. Quitting smoking is the most important step. Medicines include bronchodilators, usually taken by inhaler, to relax the muscles around the airways, and antibiotics for a bacterial lung infection. It also lists flu and pneumococcal vaccines, pulmonary rehabilitation, oxygen therapy for severe cases, and surgery as a last resort. A provider decides which of these apply.

When to get help quickly

MedlinePlus says to get emergency care for severe symptoms such as trouble catching your breath or talking, and to call your provider if symptoms are getting worse or you have signs of infection such as a fever. A cough with fever and chest pain may be pneumonia, which the pneumonia guide describes, and the cold or flu guide helps with milder illness.

Sources

• MedlinePlus — COPD
• MedlinePlus — Emphysema