COPD stands for chronic obstructive pulmonary disease. It is a relatively common condition, especially in smokers. It is a chronic disease that involves irreversible chronic bronchitis and pulmonary emphysema. COPD has some resemblances to bronchial asthma but also some significant differences.


The basically only significant risk is chronic smoking. It may be further “supported” by some genetic conditions (Alpha-1-Antitrypsin deficiency), frequent pneumonias and working in an environment with harmful gases. Chronic exposure to the cigarette smoke causes irritation of the airways and chronic bronchitis. This is related to thickening of bronchial walls and mucus overproduction. Inhaled pollutants also damage the alveoli and destruct their walls, which ensure the exchange of breathing gases. This damage is usually caused by local inflammation and oxidative stress. As alveolar walls break down, the gas exchange area is reduced and this is known as the emphysema.


COPD develops gradually over the years. It usually manifests with productive cough with phlegm expectoration. During exertion, the affected person suffers from shortness of breath. Chronically inflamed and narrowed bronchi with accumulated secretion are a suitable place for bacteria proliferation and the patient is more prone to recurrent pneumonia occurrence.


Chronic COPD can lead to the heart failure. There is a worse blood flow through lungs suffering from COPD and it is more strenuous for right heart ventricle to pump blood into the lungs. Local blood pressure increases as blood does not flow through airless alveoli and because of alveolar walls destruction. Imagine that the blood from the right heart ventricle flows into many thin tubes that start to narrow and close. The pressure created by the heart pump must grow in order to get the blood through. The right half of the heart begins to overload and it can end as a heart failure.


The best way of prevention is to quit smoking or not to begin at all. People working in environment with hazardous air pollutants and aggressive gases should use proper protective gear.


The diagnosis can be made from medical history including information about smoking and about current job. Physical examination is important as careful listening to lungs by a stethoscope can diagnose breathing changes typical for both chronic bronchitis and emphysema. Chest X-ray is a basic imaging method that shall be always executed in chronic respiratory troubles. Definitive diagnosis and determining the severity of COPD is done by functional lung tests, especially by the spirometry.


There is number of drugs that can be prescribed by a doctor. Some of them work as bronchodilators (dilate the narrowed bronchi), other have mucolytic effect (dissolve the accumulated mucus and allow its expectoration) and anti-inflammatory effect (such as corticosteroids). The medical preparations may be administered in forms of tablets or local inhalants. Inhalation is favorable as it lowers risk of any side effects of chronic therapy (for example of corticosteroids).

Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources