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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Frequently Asked Questions (FAQs)


September 10, 2014

Chronic Obstructive Pulmonary Disease
32172
Learn The Basics
Frequently Asked Questions (FAQs)
Frequently Asked Questions (FAQs)
htmFAQsCOPD
A list of the most frequently asked questions regarding chronic obstructive pulmonary disease
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InteliHealth
2011-09-02
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InteliHealth/Harvard Medical Content
2014-09-02

Reviewed by the Faculty of Harvard Medical School

 

What is the difference between chronic obstructive pulmonary disease (COPD), emphysema and bronchitis?
If you have emphysema or chronic bronchitis, you have COPD — the general term for both. Emphysema refers to the damage done to the small air sacs in your lungs. It can be diagnosed by breathing tests and computed tomography (CT, or CAT) scanning. Chronic bronchitis refers to persistent inflammation of the airways, which causes a chronic cough, usually with phlegm and shortness of breath. It is possible for you to have both emphysema and bronchitis.

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Who is at risk of COPD?
Cigarette smoking is the usual cause of COPD. Occasionally, secondhand smoke, air pollution or inhaled substances in the workplace lead to COPD in nonsmokers.
 
If you are exposed to any of these irritants, discuss ways of reducing ongoing exposure with your doctor, to prevent further damage to your lungs. If you are a nonsmoker and you have emphysema, you may want to be tested for a rare inherited enzyme deficiency (alpha1-antitrypsin deficiency).

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Is COPD inherited?
Only one type of COPD (specifically emphysema ) is known to be inherited. It is caused by a deficiency in the enzyme alpha1-antitrypsin.
Most cases of COPD are not inherited, but some studies suggest that members of certain families are more susceptible or sensitive to developing COPD if they smoke or are exposed to secondhand smoke. So if many of your relatives have COPD, don't start smoking. Or if you already smoke, take immediate steps to quit.

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Can COPD cause heart disease?
The heart and lungs work as a unit. The heart pumps oxygen-rich blood from the lungs into the arteries and pumps deoxygenated blood from the veins into the lungs for reoxygenation.
COPD can lead to obstruction and tissue damage in the lungs, decreasing oxygen levels and causing the lung's blood vessels to narrow. This makes it hard for the heart to pump blood into the lungs.
Over time, the heart muscle weakens and doesn't pump as well as it normally does. This is a type of heart failure.

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What is the cause of wheezing in COPD?
Wheezing is the musical sound produced by breathing through narrow, obstructed airways. Wheezing is most commonly associated with asthma, in which sensitive airways narrow in response to a trigger or inflammation. But wheezing can also occur in adults with COPD who have never had asthma.
In COPD, the wheezing results from airways obstructed by excess mucus and from thickened airways usually caused by years of cigarette smoking. Chronic inflammation may also irritate the airways, causing them to narrow by muscle contractions.

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How does oxygen therapy help in COPD?
Oxygen is essential for life. Your doctor will want the oxygen level your blood to be 89 percent or higher. Optimizing your blood oxygen level even while you rest is a proven way to reduce the strain of COPD on your heart and increase your overall energy level.
Because COPD depletes blood oxygen levels gradually, some people adjust to lower levels over time. They lose the ability to sense low oxygen and don't feel short of breath. If you have COPD and a low blood oxygen level, your doctor will prescribe enough oxygen to keep the oxygen level in your blood greater than 88 percent, regardless of how you feel.

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Do inhalers help in COPD?
People often think of inhalers as a quick fix for breathing problems, but inhalers are also used to maintain the health of your airways. Inhalers do two things for people with COPD:
  • They relieve airway obstruction to make breathing easier.
  • They decrease inflammation in the airways.
Because inflammation is responsible for airway blockage and tissue damage, daily use of a corticosteroid inhaler helps many people with long-term COPD control their disease. Make sure you talk to your doctor about which inhalers should be taken only as needed and which ones are for daily use.

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