Many people don't realize they have COPD because its early stages can be symptomless. As the disease progresses, symptoms begin to appear, such as

  • shortness of breath
  • difficulty breathing during activities
  • inability to take a deep breath
  • chronic cough
  • excessive phlegm
  • chest tightness
  • wheezing
  • fatigue
  • frequent respiratory infection
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Because COPD develops slowly, you may not realize your exercise tolerance is lower than normal. You and your doctor can measure tolerance by comparing certain activities you routinely performed over a one- to two-year period. For example, if you regularly climbed two flights of stairs comfortably two years ago but can't climb even one flight today, this change is potentially meaningful—even if you feel you don't have symptoms.

When your symptoms suddenly become worse, you're having an acute flare-up, or exacerbation. Flare-ups can be life threatening and require medical attention.

To manage your symptoms and prevent further lung damage, follow these tips:

  • If you smoke, quit.
  • Avoid secondhand smoke.
  • Get the pneumonia vaccine.
  • Get an annual flu shot.
  • Avoid cold air.
  • Stay away from fireplace smoke and other air pollutants.
  • Don't stop taking the drugs prescribed by your doctor, even if you feel better.
  • Plan ahead by discussing with your doctor how to prepare for acute flare-ups.
  • Call your doctor if you have signs of a respiratory infection, such as fever, more coughing, more difficulty breathing than usual, chest tightness and changes in the amount or color of phlegm.

Get medical help immediately if you have difficulty breathing or talking.

Doctor's Viewpoint

Enid R. Neptune, M.D., Associate Professor of Medicine, Pulmonary and Critical Care Medicine, Johns Hopkins

The rising number of people being diagnosed with COPD is cause for concern. Just as troubling is the fact that too few people are diagnosed in COPD's early stages, when they have a better chance of slowing the disease's progression. When it comes to chronic diseases, severe COPD symptoms can be as devastating as those of cancer and heart disease.

Quitting smoking, recognizing symptoms and partnering with your doctor to take charge of COPD are the best ways to ensure your disease never progresses to the point of disability.

Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Publication Review By: the Editorial Staff at

Published: 17 Jul 2013

Last Modified: 17 Jul 2013