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Symptoms of Chronic Obstructive Pulmonary Disease (COPD)

  • Cynthia M. Johnson, MA
Publication Type:

Condition InDepth

Symptoms of Chronic Obstructive Pulmonary Disease (COPD)

The symptoms of COPD start off mild and worsen as the disease progresses.

Normal Lung and Emphysemic Lung.

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Early Symptoms

Lack of Energy

The increased work of breathing and less oxygen can make a person feel tired with activities, or all the time.


Cough is a common symptom of COPD. It may be worse during a cold or respiratory infection.

Phlegm and Sputum

A person coughs up phlegm and sputum from deep in the lungs. This is more common with the chronic bronchitis type of the disease. The amount increases over time.


There may be a whistling or rustling sound when a person exhales. Wheezing often worsens with a cold or respiratory infection.

Shortness of Breath

This symptom starts as the disease worsens. At first, it may only happen with exercise. Then, it may happen when doing day to day tasks.

Advanced Symptoms

Severe Shortness of Breath and Chronic, Productive Cough

As the disease becomes advanced, shortness of breath may happen even when a person is at rest. It may cause a person to breathe through pursed lips or to lean forward when sitting or standing to make breathing easier. Coughing and coughing up products from deep in the lungs may make it hard to do daily activities. It may also lead to problems sleeping. A person may feel that they are choking when they are lying flat.

Blue Lips or Fingernails

A person's lips and fingernails may become blue due to lack of oxygen.

Heart Problems

COPD makes the heart work harder, especially the right side of the heart. This side pumps blood to the lungs. The walls of the heart become thick from the extra work needed to pump blood into the lungs. The normal rhythm of the heart may also change.

Fluid Buildup

The extra strain on the right side of the heart may make it hard for blood to flow. This can enlarge the veins and liver and lead to fluid leaking into the belly, legs, and ankles. This causes swelling and is a sign of heart failure.

Increased Chest Size

COPD damages the lungs and makes it hard for people to fully exhale. Air gets trapped in the lungs, which causes the chest to expand. This leads to a lasting problem called "barrel chest."

Lung Infections

The buildup of fluids and lung products make it easier for viruses and bacteria to grow. These lung infections make breathing even worse.


  • Chronic obstructive pulmonary disease (COPD). American Lung Association website. Available at: https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd.
  • COPD. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/copd.
  • Duffy SP, Criner GJ. Chronic obstructive pulmonary disease: evaluation and management. Med Clin North Am. 2019;103(3):453-461.
  • What is COPD? National Heart Lung and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/copd.


  • Mark Arredondo, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.