Symptoms of chronic obstructive pulmonary disease (COPD) vary in each individual and by stage of disease. In the earliest stages of COPD, symptoms may be barely noticeable or may be confused with other health conditions or changes associated with normal aging. As COPD progresses and the lungs become significantly more damaged, symptoms worsen and have a more severe impact on quality of life. During an exacerbation or flare-up, symptoms become much worse for a period of time.
Common symptoms of COPD are difficulty breathing, shortness of breath, chronic coughing, tightness in the chest, wheezing, increased mucus production, and ongoing fatigue. People who develop hypoxia, or low levels of oxygen in the blood, may have trouble thinking and remembering. Symptoms get worse over time as the lung damage progresses and may include frequent respiratory infections, swelling in the ankles, feet, and legs, and weight loss. Depression and anxiety are common with COPD, as with all chronic illnesses. It is common for people with COPD to have additional health problems such as heart failure, hypertension (high blood pressure), and diabetes, which may make COPD symptoms more severe.
Treatments can effectively manage many COPD symptoms and slow the progress of the disease.
Symptoms by stage of COPD
As COPD progresses to later stages, people experience more severe and varied symptoms.
People with mild COPD may or may not notice symptoms. Symptoms may be very minor such as some difficulty breathing. Many people go undiagnosed at this stage. Other early symptoms may include coughing and producing phlegm.
When COPD becomes moderate, symptoms are more pronounced and may lead people to seek a doctor’s help. Additional symptoms at this stage include shortness of breath and wheezing.
In severe COPD, quality of life is significantly impacted. People with stage 3 COPD feel increased fatigue along with worsening of other symptoms experienced in earlier stages. In later stages of COPD, some people may develop cyanosis, or a bluish tinge to the skin, due to low oxygen levels in the blood. People in later stages of COPD may experience swelling in the legs, ankles, and feet caused by pulmonary hypertension, a complication of COPD.
When COPD reaches the end stage, lung functionality is extremely limited, breathing is very difficult, and exacerbations can become life-threatening. Heart failure, tachycardia (increased heart rate), and weight loss may be experienced during end-stage COPD.
Symptoms by type of COPD
COPD is an umbrella term for several types of progressive lung disease. Many people with COPD have a combination of several types of lung disease, most commonly emphysema and chronic bronchitis. COPD symptoms vary depending on which type or types of lung disease you have.
Emphysema impairs airflow, making it difficult to breathe and get enough oxygen. People with emphysema may lose their appetite and experience unintended weight loss.
With chronic bronchitis, airways are blocked due to inflammation of the bronchial tubes and mucus build-up, causing ongoing coughing, frequent clearing of the throat, shortness of breath, wheezing, and chest pain. In later stages of COPD, people with chronic bronchitis are more likely to develop cyanosis.
Symptoms of refractory asthma include coughing, wheezing or whistling sounds during breathing, chest pain, and shortness of breath.
Symptoms include coughing up blood or mucus, shortness of breath, wheezing, fever and chills, and fatigue.
Alpha-1 antitrypsin deficiency (Alpha-1)
In addition to symptoms common in other forms of COPD, people with alpha-1 may experience year-round allergies and frequent chest infections such as pneumonia.
What are the early signs of COPD?
Typically, the earliest sign of COPD is ongoing, chronic coughing. However, many people are not diagnosed until the disease has progressed and other symptoms, such as difficulty breathing and wheezing, become noticeable.
What symptoms lead to a diagnosis of COPD?
COPD cannot be diagnosed based on symptoms alone. Doctors diagnose COPD with a combination of detailed patient history and spirometry, or lung function test. The doctor may order additional tests such as X-rays, electrocardiogram (EKG), and blood tests to rule out other possible causes of symptoms and assess how far lung damage has progressed. Read more about the process of diagnosing COPD.
At what age do most people first experience COPD symptoms?
It takes years for lung damage to progress to the point where symptoms are noticeable. COPD is most commonly found in people 40 years of age or older. People with alpha-1 often develop COPD before age 40. Some studies indicate that women and African-Americans are more likely to develop COPD at an earlier age than other populations, even if they smoke less.