Chronic obstructive pulmonary disease (COPD) gradually gets worse over time. Your symptoms depend on when COPD was diagnosed, how far along it is, and your lifestyle.

• If you are diagnosed early, before a lot of lung damage has taken place, you may have very mild symptoms, even when you are active.
• If you are diagnosed later, you may have already lost much of your lung function.
  • If you have an inactive lifestyle, you may not notice that shortness of breath is interfering with your daily activities until you have lost a greater percent of your lung function.
  • If you have an active lifestyle, you may notice shortness of breath during more strenuous activities.
  • You may have difficulty breathing while performing simple household tasks.
• If you have had COPD for many years, you may be short of breath even when resting. If this is the case, even simple activities cause severe shortness of breath.

If you continue smoking after being diagnosed with COPD, the disease will progress faster, resulting in more severe symptoms and a greater risk of developing complications.

• You may become short of breath when doing light activities.
• You may feel short of breath, even while resting.
• Your lung function will decrease faster than that of a nonsmoker of the same age.

See a graph on how smoking affects the ability to breathe.

The lung damage that causes symptoms of COPD does not heal and cannot be repaired. But if you have mild to moderate COPD and stop smoking, you can slow the rate at which breathing becomes more difficult. You will never be able to breathe as well as you would have if you had never smoked, but you may be able to postpone or avoid more serious problems with breathing.

Complications

Complications of COPD may include:

• A sudden and prolonged worsening of coughing, shortness of breath, and/or mucus production (COPD exacerbation).
• More frequent lung infections, such as pneumonia.
• An increased risk of thinning of the bones (osteoporosis), especially if you use oral corticosteroids.
• Depression. COPD may limit your ability to work and reduce your independence, sexual activity, social activities, and self-esteem. This often results in depression.
• Problems with weight. If chronic bronchitis is the main component of your COPD, you may need to lose weight. If emphysema is your main component, you may need to gain weight and muscle mass.
• Heart failure affecting the right side of the heart (cor pulmonale).
• A collapsed lung (pneumothorax). COPD can damage the lung's structure and allow air to leak into the chest cavity.
• Sleep problems because you are not getting enough oxygen into your lungs.

Treatment for COPD is increasingly successful at prolonging life. However, COPD is a progressive and potentially fatal disease. You and your health professional should discuss what types of medical treatment you want to receive if sudden, life-threatening breathing problems develop, such as whether you want to receive mechanical ventilation. This discussion may include the possibility of your creating an advance directive to state your wishes if you become unable to communicate them. For more information, see the topics Writing an Advance Directive and Care at the End of Life.