The co-existence of chronic bronchitis and emphysema is known as chronic obstructive pulmonary disease (COPD); a disease for which there is no cure. Bronchitis and emphysema are both diseases in which the airways of the lungs become constricted, resulting in a decreased flow of oxygen, which causes dyspnea (shortness of breath). The cause of COPD is inhalation of tobacco smoke, gases and other particles damaging to the lungs.
Most patients with COPD suffer from dyspnea. Over time, COPD and dyspnea usually get increasingly worse, with the airflow in the lungs getting progressively lower. In addition to dyspnea, people with COPD may have chest tightness, rapid breathing, exhaustion, enlargement of the chest cavity, exhalation taking longer than inhalation, wheezing, active use of neck muscles to aid in breathing, and a persistent cough and/or mucus production in chronic bronchitis.
The narrowed airways in the lungs, as characterized by COPD, limit the lungs’ efficiency and cause dyspnea. People with COPD suffer from pressure and compression in the chest during exhalation instead of the normal and healthy expansion of the airways. For this reason, expiration (exhalation) may take longer for COPD patients than inhalation. Many COPD patients are incapable of finishing a breath out before needing to inhale again, the result being that some air from the first breath remains inside the lungs during the next breath. This discrepancy causes dynamic hyperinflation (an increased volume of air in the lungs), which causes shortness of breath as it becomes increasingly difficult for patients to breathe with their chest cavities already expanded.
The second cause of dyspnea in COPD is due to emphysema. In emphysema, the surface area accessible for the exchange of oxygen and carbon dioxide in the lungs is decreased, causing a diminution in the rate of transfer of these gases during breathing. This diminution results in low oxygen and high carbon dioxide levels in the body. People with emphysema commonly have increased breathing rates and/or take deeper breaths to compensate, but this is made difficult by the lungs’ oxygen flow limitation and/or dynamic hyperinflation.
Advanced COPD cases can include respiratory failure, causing patients’ lips to turn blue from the lack of oxygen in their blood. This lack of oxygen results in an overload of carbon dioxide, which may cause headaches, twitching, and drowsiness. In addition, extra work is required by the heart in order to pump adequate amounts of blood through the affected lungs. This strain on the heart could cause cor pulmonale (right-sided heart failure), resulting in swelling of the ankles and dyspnea. Other symptoms of advanced COPD include weight loss and pulmonary hypertension.
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