When you have
COPD, especially if you have chronic
bronchitis, you may sometimes have sudden attacks
where your breathing and coughing symptoms suddenly get worse and stay that
way. These attacks are called COPD exacerbations, or flare-ups.
With treatment, many people recover and return to the same level of shortness
of breath they had before the attack.
These attacks may be
life-threatening. If your symptoms suddenly get worse, and if taking your
medicine doesn't help, have someone take you to the emergency room. Call
911 if needed.
often occur more frequently, last longer, and are more severe the longer you
The two most
common causes of a COPD attack are:1
Having other health problems, such as heart failure or an abnormal heartbeat (arrhythmia) may also trigger a flare-up. In about 33
out of 100 attacks—about a third—the cause is not known.1
Here's what happens during an attack:
- Your lungs may suddenly produce more
mucus. Or the airways of your lungs (bronchial tubes)
may suddenly get narrower.
- These two things reduce the airflow in
- And that makes it harder to breathe and makes your
In a COPD
attack, your usual symptoms suddenly get worse:
- You have more shortness of breath and
- You have more coughing, with or without
- You may cough up more mucus than
usual, and it may be a different color.
Some people also have a fever, insomnia, fatigue, depression,
Treatment of a COPD attack depends on how bad it is. It may involve several
visits to your doctor's office or clinic. Or you may need to be treated in the
To treat COPD attacks, experts recommend:
- Quick relief (short-acting), inhaled bronchodilatorsinhaled bronchodilators,
which are medicines that relax the bronchial tubes and make it easier to
breathe. These medicines may include:
- Anticholinergics (such as ipratropium).
- Beta2-agonists (such as albuterol).
- Oral corticosteroid medicines, which
reduce the swelling in your airways and may make breathing
easier. They are typically given for 5 days to up to 14 days to those who
aren't already taking them as part of their long-term treatment.
- A machine to help you breathe. This is
called mechanical ventilation. It is used only if medicine is not helping and
you are having a very hard time breathing.
- Oxygen, to increase the amount of oxygen in your
Treatment may also include: