Four fast COPD facts: Chronic obstructive pulmonary disease

Nearly 15 million people in the U.S. have been diagnosed with Chronic Obstructive Pulmonary Disease (COPD), and it’s estimated that another 12 million people have the condition but have not yet been diagnosed. COPD is also the fourth leading cause of death in the U.S., resulting in 150,000 deaths every year. Here are important COPD facts to know about this lung condition.

1. There are two main forms of COPD

Emphysema and chronic bronchitis are the two forms that comprise COPD. Some patients have one or the other, and some patients have a combination of both.

Emphysema occurs when the small air sacs in the lungs, called alveoli, lose their elasticity, so air gets trapped in them instead of being properly inhaled and exhaled. Also, these air sacs can rupture, forming large pockets that reduce the surface area of the lungs and reduce the amount of oxygen supplied to the rest of the body. 

Chronic bronchitis happens when tiny hairs that line the airways called cilia are damaged, leading to increased airway inflammation and mucous production. Patients with chronic bronchitis often have a lingering cough. They’re also prone to episodes of acute bronchitis when the airway is not only inflamed but also infected. 

2. COPD can cause multiple symptoms

Regardless of whether a patient has emphysema or chronic bronchitis (or both), the symptoms are similar. Common symptoms include a cough, shortness of breath, wheezing, excess phlegm production, fatigue, and frequent respiratory infections. 

While symptoms in patients with early COPD are often mild, patients with late-stage COPD can have significant symptoms, including weight loss, low blood oxygen levels, difficulty eating, muscle weakness, blue lips or nail beds, and delirium or confusion caused by a lack of oxygen in the brain.

3. Several tools help diagnose COPD.

COPD is divided into four stages, with Stage 1 being the earliest, mildest form of the disease and Stage 4 being the most advanced stage of the disease. Healthcare providers use several tools to determine if a patient has COPD, and what stage their disease is.

First, providers take a detailed history, check vital signs, and perform a physical exam. On exam, COPD patients can have a fast heart rate, low oxygen, and crackles or wheeze in the lungs. Patients with significant COPD also typically have nail clubbing, a condition in which the fingertips become enlarged, and the nail becomes curved like an upside-down spoon, a result of chronically low oxygen levels.

Imaging, including a chest X-ray or chest CT scan, can be used to evaluate COPD as well. Patients with COPD are often noted to have enlarged lungs, a flattened diaphragm, or abnormal air pockets in the lungs.

In addition to the above tools, a pulmonary function test called spirometry is an accurate way to diagnose and stage COPD. Spirometry is performed by having a patient blow into a computerized device called a spirometer, which measures lung capacity and other metrics that determine lung function.

4. COPD is treatable, not curable.

There is no known cure for COPD, but thankfully several treatment options are available.

Next, it’s important for patients with COPD to stay up to date with vaccines that prevent respiratory infections including influenza, COVID-19, and bacterial pneumonia. 

Other treatment options include rapid-acting and long-acting inhalers. Oral medications, including antibiotics and steroids, can also be helpful. And for patients with advanced COPD, nebulizer treatments, supplemental oxygen, and I.V. steroids are often used as well.

Sources:

https://www.cdc.gov/copd/index.html

https://medlineplus.gov/ency/article/000091.htm

https://www.lung.org/lung-health-diseases/lung-disease-lookup/emphysema

Written by Sarah Thebarge, Physician Assistant