COPD (Chronic Obstructive Pulmonary Disease)


Chronic obstructive pulmonary disease (COPD) is a chronic condition in which there is a slow, progressive obstruction of airflow into or out of the lungs.

Symptoms of chronic obstructive pulmonary disease include

  • cough,
  • chest discomfort,
  • shortness of breath, and
  • wheezing.

Progressive or more serious symptoms may include

  • respiratory distress,
  • tachypnea,
  • cyanosis,
  • use of accessory respiratory muscles,
  • peripheral edema,
  • hyperinflation,
  • chronic wheezing,
  • abnormal lung sounds,
  • prolonged expiration,
  • elevated jugular venous pulse, and
  • cyanosis.

The primary cause of chronic obstructive pulmonary disease is cigarette smoking and/or exposure to tobacco smoke. Other causes include air pollution, infectious diseases, and genetic conditions. The risk factors of COPD is increased by smoking tobacco, second hand smoke, air pollution, alpha-1 antitrypsin deficiency and a few other conditions.

Chronic bronchitis, emphysema, asthma, and infectious diseases can contribute to the development of chronic obstructive pulmonary disease.

Risk factors for developing COPD

There is a genetic factor called alpha-1 antitrypsin deficiency that places a small percentage (less than 1%) of people at higher risk for COPD (and emphysema) because a protective factor (alpha-1 antitrypsin protein) for lung tissue elasticity is decreased or absent. Other factors that may increase the risk for developing chronic obstructive pulmonary disease include

  • intravenous drug use,
  • immune deficiency syndromes,
  • vasculitis syndrome,
  • connective tissue disorders, and
  • genetic problems such as Salla disease (autosomal recessive disorder of sialic acid storage in the body).

Other diseases or conditions contribute to COPD

In general, three other non-genetic problems related to the lung tissue play a role in chronic obstructive pulmonary disease. 1) chronic bronchitis, 2) emphysema, and 3) infectious diseases of the lung.

  • Chronic bronchitis and emphysema, are thought by many to be variations of chronic obstructive pulmonary disease and considered part of the progression of chronic obstructive pulmonary disease by many researchers. Chronic bronchitis is defined as a chronic cough that produces sputum for three or more months during two consecutive years.
  • Emphysema is an abnormal and permanent enlargement of the air spaces (alveoli) located at the end of the terminal bronchioles in the lungs.
  • Infectious diseases of the lung may damage areas of the lung tissue and contribute to chronic obstructive pulmonary disease.

Tests to diagnose COPD

Preliminary diagnosis of COPD in a person with chronic obstructive pulmonary disease symptoms by noting

  • his/her breathing history,
  • the history of tobacco smoking or exposure to secondhand smoke, and/or
  • exposure to air pollutants, and/or a history of lung disease (for example, pneumonia).

Treatment for COPD

Medical treatments of chronic obstructive pulmonary disease drugs, for example, nicotine replacement therapy, beta-2 agonists and anticholinergic agents (bronchodilators), combined drugs using steroids and long-acting bronchodilators, mucolytic agents, oxygen therapy, and surgical procedures such as bullectomy, lung volume reduction surgery, and lung transplantation.

  • Stage I - short-acting bronchodilator as needed
  • Stage II - short-acting bronchodilator as needed and long-acting bronchodilators plus cardiopulmonary rehabilitation
  • Stage III - short-acting bronchodilator as needed long-acting bronchodilators cardiopulmonary rehabilitation and inhaled glucocorticoids for repeated exacerbations
  • Stage IV - as needed, long-acting bronchodilators, cardiopulmonary rehabilitation, inhaled glucocorticoids, long-term oxygen therapy, possible lung volume reduction surgery and possible lung transplantation (stage IV has been termed "end-stage" chronic obstructive pulmonary disease)