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What is Chronic Obstructive Pulmonary Disease?

Difficulty breathing, coughing, mucus (sputum) production and wheezing. These are some of the symptoms of chronic obstructive pulmonary disease (COPD). Most people develop COPD from a history of smoking, exposure to second-hand cigarette smoke or exposure to irritating gases or particulate matter.

At first, symptoms of COPD can be quite mild. You might mistake them for a cold. Early symptoms include occasional shortness of breath – especially after exercise, mild but recurrent cough, and needing to clear your throat often, especially first thing in the morning. However, over time COPD symptoms can get progressively worse and harder to ignore. As the lungs become more damaged, you may experience:

1.     shortness of breath- after even mild forms of exercise like walking up a flight of stairs,

2.     wheezing- which is a type of higher-pitched noisy breathing, especially during exhalations, 

3.     chest tightness, 

4.     chronic cough- with or without mucus, 

5.     need to clear mucus from your lungs every day, 

6.     frequent colds, flu, or other respiratory infections and 

7.     lack of energy. 

In later stages of COPD, symptoms may also include, fatigue, swelling of the feet, ankles, or legs and weight loss. 

People with COPD have an increased risk of developing heart disease, lung cancer and other conditions. Emphysema and chronic bronchitis are the two most common conditions that contribute to COPD. They usually occur together and can vary in severity among individuals. 

Chronic bronchitis is inflammation of the bronchial tubes lining, which carry air to and from the air sacs of the lungs. This causes mucus to build up in the airways, making it difficult to breathe. Emphysema causes the alveoli at the end of the smallest air passages of the lungs to be destroyed from cigarette smoke exposure and other irritating gases. This eventually leads to destruction of these air sacs, impacting air flow causing difficulty breathing and poor oxygen exchange. 

Approximately 138,500 individuals aged 45 or older in B.C. have been diagnosed with COPD, which equals six per cent of residents in that age group. Many have unrecognized COPD and remain undiagnosed. As there is no specific one exam to test for COPD, COPD is rather diagnosed based on medical history, physical examination, presenting symptoms and diagnostic exams. 

Some exams your physician may perform are:

1.     Spirometry is a non-invasive test to assess lung function. During the test, you’ll take a deep breath and then blow into a tube connected to the spirometer.

2.     Imaging tests, like a chest X-ray or CT scan. These images can provide a detailed look at your lungs, blood vessels, and heart.

3.     An arterial blood gas test. This involves taking a blood sample from an artery to measure your blood oxygen, carbon dioxide, and other important levels.

These tests can help determine if you have COPD or a different condition, such as asthma, a restrictive lung disease, or heart failure.

While examining you for COPD, your physician will want to rule out asthma and asthma-COPD overlap syndrome (ACOS), as these are the two primary differential diagnoses to rule out. Alternative diagnoses include heart failure in older adults, when breathlessness is out of proportion to spirometry results; measuring B-type natriuretic peptide levels may help in finding heart failure and tuberculosis.

There are treatments available, and they can ease symptoms, prevent complications, and generally slow disease progression. Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory therapists. Most treatment is either oxygen supplementation, surgery, inhaled bronchodilators or Corticosteroids

For more information, contact the Medical Arts Health Research Group at or visit our website at