The symptoms of COPD are mild at first. They become more severe and debilitating as the disease progresses.
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Early Symptoms of COPD
The increased work of breathing and lower oxygen may make you tired with activities, or all the time.
Cough that produces a lot of mucus is a common symptom of COPD. Coughing may be worse during a cold or respiratory infection.
More common with chronic bronchitis type. Production increases over time.
A whistling or rustling sound may be heard when exhaling, which is prolonged. Wheezing often worsens with a cold or respiratory infection.
This symptom develops as COPD becomes progressively worse. At first, shortness of breath may only occur with physical exertion. As the disease becomes more advanced, it may occur after very modest activity. When the illness becomes very severe, shortness of breath occurs even at rest.
Symptoms of More Advanced COPD
Even very mild activities produce significant shortness of breath. Repeated bouts of coughing with sputum production may become disabling. Nighttime coughing may interfere with sleep. You may feel a choking sensation when lying flat. Difficulty breathing may cause sufferers to breathe through pursed lips, or to lean forward when sitting or standing in order to breathe more comfortably.
As your ability to take in oxygen gets worse, it may become low enough to change the color of your lips and fingernails. This is called cyanosis.
COPD makes the heart work harder, especially the right side of the heart. This side pumps blood to the lungs. The walls of the heart become thickened from the extra work needed to pump blood into the resistant lungs. The normal rhythm of the heart may be disturbed. Lack of oxygen in your blood can produce a bluish tinge to your skin, nails, and lips.
The extra strain on the right side of the heart may cause a slowdown of blood circulation. This, in turn, can cause engorgement of the large veins and liver, and eventually fluid leakage into the abdomen, legs, and ankles (edema). This right-sided heart failure is called cor pulmonale.
Because COPD destroys the normal lung structure, you cannot exhale completely. Air is trapped in the lungs, which become hyperinflated. This causes the chest to expand, leading to a permanent condition referred to as “barrel chest.”
The accumulation of mucus and fluid in the lungs provides an ideal environment for bacteria and viruses to grow. These lung infections may become serious, further compromising breathing ability.
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COPD symptoms, causes, and risk factors. American Lung Association website. Available at: http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/symptoms-causes-risk-factors. Updated November 1, 2016. Accessed February 22, 2017.
Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2017. Global Initiative for Chronic Obstructive Lung Disease website. Available at: http://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd. Accessed February 22, 2017.
What are the signs and symptoms of COPD? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/copd/signs. Updated July 31, 2013. Accessed February 22, 2017.
Last reviewed February 2017 by Michael Woods, MD, FAAP Last Updated: 3/15/2015