COPD Complications and Other Conditions

Medically Reviewed by Paul Boyce, MD on March 01, 2024
6 min read

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.

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.

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.

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 decrease your breathing rate. 

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 right-sided heart failure, a permanent condition in which your heart is too weak to do its job well.

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.

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.

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.

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.

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.

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.

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.

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.

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.

You’re more likely to get lung cancer if you have COPD because both conditions share the same risk factor: smoking cigarettes. And when you do get it, the outcome after diagnosis and treatment tends to be worse than someone without COPD.

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.

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.