COPD Flare-Up Advice

COPD complications can be serious. Johns Hopkins specialists provide bottom line advice to help you recognize a COPD problem before it turns dangerous.

If you have COPD, how do you know when you're not merely in discomfort, but in danger? Here are some danger signs that you shouldn’t ignore.

• COPD flare-ups and infections. If you feel increasing shortness of breath, more mucus in your throat, and greater wheezing and coughing than usual, you may be experiencing a COPD flare-up -- something you need to share with your doctor. You should also call if the material you cough up changes color or if you have a fever lasting more than 24 hours. COPD flare-ups often result from a bronchial infection, which may be treatable with antibiotics, or from breathing fumes, dust, or pollution.
• COPD and heart failure. Swelling of the legs, ankles, and feet is a warning that someone with COPD may have developed a type of heart failure called cor pulmonale, or right ventricular failure. Because COPD makes the heart work harder (particularly the right side, which pumps blood into the lungs), that side of the heart may enlarge. As the blood pressure in the lungs rises, the right ventricle contracts less efficiently. Cor pulmonale increases the risk that a blood clot will develop in a leg vein.
• COPD and pneumothorax. A hole that develops in the lung, allowing air to escape into the space between the lung and the chest wall, pneumothorax causes the lung to collapse, leading to severe shortness of breath. People with COPD have an increased risk of pneumothorax, because changes in their lungs cause air to be emptied unevenly from the lungs. Symptoms of pneumothorax include: sudden shortness of breath; painful breathing; sharp chest pain, often on one side; chest tightness; dry, hacking cough; rapid heart rate.
• COPD and too many red blood cells. Weakness, headaches, fatigue, and light-headedness may indicate the presence of an uncommon condition known as secondary polycythemia, which arises when there isn’t enough oxygen in the blood. Someone who develops polycythemia may have visual disturbances such as blind spots, distorted vision, and flashes of light. Gums and small cuts may bleed, and there may be a burning sensation in the hands and the feet.

Bottom line advice on COPD: If the problem is a flare-up of COPD, quick treatment can prevent serious breathing problems that might send you to the hospital. Call your doctor immediately if:

• You have COPD and you have shortness of breath or wheezing that is rapidly worsening.
• You have COPD and are coughing more deeply or more frequently, especially if you have an increase in mucus or a change in the color of the mucus you cough up.
• You have COPD and cough up blood.
• You have COPD and have increased swelling in your legs or abdomen.
• You have COPD and have a fever over 100°F.
• You have COPD and have severe chest pain.
• You have COPD and develop flu-like symptoms.
• You have COPD and feel that your medication is not working as well as usual.