Severe Symptoms of COPD

Reviewed by: HU Medical Review Board | Last reviewed: July 2015.

People with chronic obstructive pulmonary disease (COPD) sometimes have severe symptoms. These symptoms are “severe” because they can be a sign of serious problems and need to be treated right away. These symptoms include:1,2,3

  • Having extreme difficulty “catching your breath” or talking
  • Having a very rapid heartbeat
  • Having very rapid breathing
  • Being confused
  • Not being mentally alert, or having slower mental functioning
  • Feeling excessively sleepy or drowsy

Severe COPD symptoms are much more common for people who are in the later stages of the disease. However, it is possible for people in earlier stages of the disease to have them too.

If a patient has severe COPD symptoms, it may be a sign of a seriously acute exacerbation. An exacerbation is also called a COPD attack, or “flare-up.” It may even mean that the person is having respiratory failure. It is urgent for patients to seek medical help for these symptoms right away.

What is the cause of severe COPD symptoms?

A serious problem called “respiratory failure” is often the cause of the severe symptoms4. Respiratory failure happens to people when:

  • There is not enough oxygen in their blood
  • There is too much carbon dioxide in their blood

Oxygen is a gas that fuels all of the body’s functions. Carbon dioxide is the waste product of those functions, and needs to be removed from the body. Healthy lungs regularly absorb oxygen from the air we breathe in, and breathe out the carbon dioxide waste.

Serious problems can occur if the body does not receive enough oxygen, or if too much carbon dioxide builds up. For instance, not having enough oxygen in the blood due to respiratory failure can cause:

Having too much carbon dioxide in the blood due to respiratory failure can cause:

  • Excessive sleepiness or drowsiness
  • Rapid breathing
  • Rapid heartbeat

In many cases, the patient’s severe symptom - or symptoms – are caused by a combination of too little oxygen and too much carbon dioxide in the blood.

Respiratory failure: a severe symptom

There are several ways that COPD can cause respiratory failure4, especially during the later disease stages. Chronic bronchitis can cause the airways to become blocked by swelling and excess mucus. This means that not enough air is able to reach the lungs to deliver oxygen.

Millions of tiny air sacs in the lungs absorb oxygen from the air a person breathes in. Emphysema causes those air sacs to be damaged or destroyed, so there are fewer air sacs to absorb oxygen. It also makes it harder to breathe out, which causes carbon dioxide to become trapped in the lungs and bloodstream.

How are severe COPD symptoms treated?

Severe symptoms often require hospitalization for treatment4,5. Respiratory failure can be very serious, and even life threatening, so patients often need to be treated in the hospital. However, some patients can be treated at home, or can continue treatment at home after the hospital.

If a person with COPD has any of the severe symptoms, it is very important to contact a healthcare provider quickly. It is useful to have a COPD Action Plan ready to help recognize the severe symptoms and to know who to contact in case the patient needs emergency medical help.

The first step in treating the severe symptoms is to help get more oxygen into the patient’s bloodstream and body. Oxygen therapy provides the body with extra oxygen delivered through a mask over the nose and mouth, or through a tube in the nostrils. If the symptoms are very severe, the patient might need to be treated with a ventilator. A ventilator helps the patient to breathe by pushing air with extra oxygen into the lungs.

Treatment can also include medicines to treat the cause of the respiratory failure, such as:

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