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COPD Exacerbation Symptoms: Wheezing, Coughing, and More

WebMD Medical Reference from the COPD Foundation


Early warning signs of an acute exacerbation are unique to each person. Usually you are the best person to know if you are having sustained breathing problems. However, some changes are more likely to be noticed by other persons. So it is important to share this information with your family and those close to you.

The most common signs and symptoms of an acute exacerbation are:

  • Worsening of your stable condition
  • Increased difficulty breathing, even at rest
  • Increased wheezing
  • Increased coughing
  • Increased mucus production
  • A change in how the mucus looks. This may include being more thick and sticky. Or having a change in color from clear or white to yellowish or green, or containing blood
  • Chest tightness
  • Irritability and/or change in personality
  • Fluid retention (swelling in the hands or feet)
  • Forgetfulness, confusion, slurring of speech and sleepiness

Sometimes, an exacerbation can come with:

  • An increased feeling of fatigue and a long period of lack of energy
  • Use of more pillows or sleeping in a chair instead of a bed to avoid shortness of breath
  • Fever
  • Skin tone changes to "ashen" or "blue" color. This is especially seen in the fingertips and/or lips. This is known as cyanosis.
  • Increasing morning headaches, dizzy spells and restlessness
  • A need to increase your oxygen flow, if you are on oxygen
  • Rapid breathing. It is important to know your respiratory rate when you are feeling good. This is called a "baseline" rate. Since your rate of breathing can be easily affected by self-consciousness, have someone else count your respirations
  • Rapid heart rate. It is important to know your baseline heart rate

Measuring Your Respirations for One Minute:

1. Place the hand on the upper chest to feel it rise and fall. Each rise/fall cycle counts as one respiration.

2. Count for 30 seconds and multiply the number by two.

Measuring Your Heart Rate for one Minute:

1. Find carotid pulse. Put your index and middle finger to the side of the windpipe underneath the chin. Don''t press too hard and don''t rub.

2. Count pulse for six seconds.

3. Place "0" on end of count. (Equals beats/minute.)

A pulse oximeter on your fingertip quickly and easily measures your pulse rate and your oxygen saturation.

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