COPD Complications and Other Conditions

Reviewed by Carol DerSarkissian on September 11, 2019

COPD makes it hard to breathe in as much air as you need. And without enough oxygen, you may have other problems.

Fortunately, there are simple things you can do. Stop smoking, exercise, and closely follow your doctor's instructions about treating your COPD to prevent many of these complications.

Lung Infections

Your disease makes it harder to fight off lung infections like pneumonia. Getting sick can then make it harder for you to breathe.

Prevention is a must. Talk to your doctor about which vaccines to get. Some are for pneumonia, while others target illnesses that can make you more prone to pneumonia, like the flu and whooping cough. Wash your hands often to avoid picking up these germs.

Collapsed Lung (Pneumothorax)

COPD can damage lung tissue. And if air leaks into the space between a lung and your chest wall, that lung can collapse like a deflated balloon. You might have sudden shortness of breath, feel sharp chest pain or tightness, or have a hacking cough.

Treatments range from extra oxygen to surgery. To help prevent a collapsed lung from happening, stop smoking and see your COPD doctor regularly.

Poor Gas Exchange

Blood carries oxygen to cells throughout your body and carbon dioxide away from them. But because you're not breathing in and out fully, you may have less oxygen than you need or more carbon dioxide than you should in your blood. Either of these may be why you have shortness of breath. A high carbon dioxide level can also give you a headache and make you woozy.

A simple device called an oximeter that goes on your fingertip can check your oxygen level. Extra oxygen should help get that level up to where your doctor recommends. But if you're using oxygen, keep the flow within the range your doctor prescribed. Sometimes, too much oxygen can cause serious problems.

Heart Problems

Low blood oxygen levels can lead to narrowed arteries and higher blood pressure in the blood vessels that go from your heart to your lungs, as well as within your lungs. That can put a lot of stress on your heart, making it work harder than it should. It could become heart failure, a permanent condition in which your heart is too weak to do its job well.

Continued

The right side of your heart may get bigger. Doctors call this cor pulmonale. It can cause irregular heartbeats, trouble with blood circulation, an enlarged liver, and swelling in your feet and legs.

Being active helps keep your blood moving so you're less likely to get serious blood clots that can travel to your lungs.

Atrial Fibrillation

COPD can damage nerve fibers that connect to the heart and cause unusual heartbeats called arrhythmia. Atrial fibrillation (AFib) is the most common arrhythmia. In a study of more than 1.3 million people with COPD, about 18% also had AFib.

It’s caused by erratic beating in your heart’s two upper chambers, the atria. Some people describe AFib as feeling like a flutter, a racing heart, skipped beats, or lightheadedness, but others feel nothing at all.

AFib is more likely to start as your COPD worsens. If you have both conditions, it’s important to control them. AFib complicates COPD, and COPD can make it harder for AFib treatments to work.

Continued

Follow your doctor’s advice to keep your COPD symptoms and AFib in check. Doing that will go a long way toward keeping you healthier longer. And, if you smoke, stop. Smoking can cause physical changes in your atria that can lead to or worsen AFib.

Treatment for AFib may include taking medications or getting a procedure called cardioversion, which sends electrical impulses to your heart to restore it to a regular rhythm.

Thinning Bones (Osteoporosis)

It's common for people with COPD to get osteoporosis. They've often been smokers, they take steroids, it's hard for them to get enough bone-strengthening exercise, and they can be low on bone-building vitamin D.

Brittle, weak bones break more easily. And a break will sideline you from activity.

Protect your bones with weight-bearing exercise like walking and strength training with stretchy bands. Learn how to prevent falls.

Your doctor may want to check your bone density with the painless X-ray test called a DEXA scan. They might want you to take calcium and vitamin D supplements or bone-building drugs.

Weak Arms and Legs

Some of the same things that cause bone loss can cause muscle loss, too. Those weak muscles make it even harder to do everyday activities.

Ask your doctor to check how well your limbs work. A pulmonary rehab program can help preserve muscle. It may include strength training to build up muscle tissue you've lost.

Weight Issues

When you're overweight, your lungs have to work harder. This can make your COPD worse and complications more likely.

As COPD progresses, you might have the opposite problem: severe weight loss, sometimes because you're too short of breath to eat enough. Being underweight can also worsen symptoms and make you more vulnerable to bone thinning and infections.

Whether you need to lose or gain weight, your doctor or a registered dietitian can tell you how many calories you should get each day. And you may need supplements, like extra protein and vitamins.

Sleep Problems

COPD symptoms can wake you up during the night, which will leave you tired during the day. Even more serious is sleep apnea, a condition in which you have repeated pauses in breathing while you sleep. The pauses, along with low oxygen levels, could make your COPD worse.

Continued

Ask your doctor if you should get tested for sleep apnea. If you have it, you can use a breathing device called a CPAP machine when sleeping. Extra oxygen might help, too.

Untreated sleep apnea raises the chance of high blood pressure, heart disease, and stroke.

Diabetes

Many people with COPD have diabetes. The damage caused by one can make the other more likely.

Exercise and quitting smoking help with both conditions. Also make sure that all of your doctors know what the others have prescribed.

Depression and Anxiety

At least 1 in 10 people with early COPD get depression or anxiety, and that number climbs as the disease gets worse. Medication can help, along with exercise and even music therapy.

Work with your doctor or a therapist on self-care skills, too. People who problem-solve do better physically and emotionally than people who ignore health issues.

Lung Cancer

You’re more likely to get lung cancer if you have COPD. And when you do get it, the outcome after diagnosis and treatment tends to be worse than someone without COPD.

Some scientists think the two disease are different aspects of the same condition. Others think that COPD is a driving factor that simply raises your risk for lung cancer.

Pulmonary Hypertension

This means the pressure in the blood vessels from the heart to the lungs is too high, which causes excess muscle in the wall of the blood vessels. It’s a common and serious complication of COPD. Symptoms include breathlessness and tiredness that typically get worse with exercise or sleep.

Pulmonary hypertension often worsens symptoms and outcomes for people with COPD and shortens lifespan as well.

It’s also likely to increase the need for medical services including medication, assessments, and therapies.

Secondary Polycythemia

The “polycythemia” means that the number of red blood cells has increased. The “secondary” means that it is the result of an underlying condition like sleep apnea, obesity hypoventilation syndrome, and COPD.

COPD lessens oxygen, which can raise levels of erythropoietin and lead to secondary polycythemia. You might have a headache and feel tired, sluggish, or confused. It also raises your risk for stroke

Proper treatment of the underlying condition -- in this case COPD -- can help control secondary polycythemia.

WebMD Medical Reference

Sources

SOURCES:

Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine: "Osteoporosis in Chronic Obstructive Pulmonary Disease."

National Heart, Lung, and Blood Institute: "COPD Prevention."

Merck Manual Consumer Version: "Chronic Obstructive Pulmonary Disease (Chronic Bronchitis; Emphysema)."

COPD Foundation: "Staying Healthy and Avoiding Pneumonia."

Johns Hopkins Medicine. Guide to New Treatments for COPD, MediZine LLC, 2009.

Cleveland Clinic: "Collapsed lung," "Nutritional Guidelines for People with COPD."

UpToDate: Patient education: "Chronic obstructive pulmonary disease (COPD) treatments (Beyond the Basics)."

Lung Foundation Australia: "Carbon Dioxide Retention in Patients with Chronic Obstructive Pulmonary Disease."

Chest Foundation: "Learn About Pulmonary Vascular Disease."

American Heart Association, Answers by Heart fact sheet: "What is Heart Failure?"

Merck Manual Professional Version: "Cor Pulmonale."

Current Opinion in Pulmonary Medicine: "Coexisting chronic obstructive pulmonary disease and heart failure: implications for treatment, course and mortality."

Respiratory Medicine: "Cardiovascular autonomic neuropathy in chronic obstructive pulmonary disease," "AIR: Advances in Respiration -- Music therapy in the treatment of chronic pulmonary disease."

Proceedings of the American Thoracic Society: "Cardiac Disease in Chronic Obstructive Pulmonary Disease."

Cochrane Database of Systematic Reviews: Plain Language Summaries: "Nutritional supplementation for stable chronic obstructive pulmonary disease."

American Journal of Respiratory and Critical Care Medicine: "Musculoskeletal Effects of Chronic Obstructive Pulmonary Disease Prevalent, Linked, but Ignored," "An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease," "Sleep Problems in Asthma and COPD."

International Journal of General Medicine: "Obesity and respiratory diseases."

Journal of Clinical Sleep Medicine: "Impact of CPAP Use and Age on Mortality in Patients with Combined COPD and Obstructive Sleep Apnea: The Overlap Syndrome."

International Journal of Chronic Obstructive Pulmonary Disease: "Managing comorbidities in COPD," "Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD," "The impact of coping on the somatic and mental status of patients with COPD: a cross-sectional study."

COPD Research and Practice: "Chronic obstructive pulmonary disease and diabetes."

CDC: "COPD," “Atrial Fibrillation Fact Sheet.”

Tobacco Induced Diseases: "Depression, anxiety and panic disorders in chronic obstructive pulmonary disease patients: correlations with tobacco use, disease severity and quality of life."

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews: "The effect of complex interventions on depression and anxiety in chronic obstructive pulmonary disease: systematic review and meta-analysis."

Chronic Obstructive Pulmonary Disease Open Access: “The Association between Chronic Obstructive Pulmonary Disease (COPD) and Atrial Fibrillation: A Review.”

COPD.net: “Atrial Fibrillation: Here’s What to Know.”

Drugs.com: “Glucocorticoids,” “Non-cardioselective Beta Blockers.”

Journal of Cardiology: “Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship.”

Mayo Clinic: “Albuterol (Inhalation Route)," “Atrial Fibrillation,” “Cardioversion.”

Oncotarget: “The progression in atrial fibrillation patients with COPD: a systematic review and meta-analysis.”

Pulmonary Advisor: “Atrial Fibrillation Prevalence Increasing in End-Stage COPD.”

American Journal of Respiratory and Critical Care Medicine: “Lung Cancer in Chronic Obstructive Pulmonary Disease. Enhancing Surgical Options and Outcomes.”

Lung Cancer: “The relationship between COPD and lung cancer.”

International Journal of Chronic Obstructive Pulmonary Disease: “Updated Perspectives on Pulmonary Hypertension in COPD.”

The European Respiratory Journal: “Pulmonary hypertension in COPD.”

CDC: “Pulmonary Hypertension.”

British National Health Service: “Polycythaemia.”

Medscape: “Secondary Polycythemia.”

© 2019 WebMD, LLC. All rights reserved.

Pagination