What to know about congestive heart failure and COPD

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COPD is a separate condition from CHF, but it may cause a person to develop heart failure.

The American Heart Association (AHA) notes that severe lung diseases, which include COPD, are among the conditions that can lead to heart failure. When the lungs struggle to bring in enough oxygen, this puts additional strain on the heart.

Many other conditions can cause CHF or have an association with it. These include:

• coronary artery disease
• high blood pressure
• previous heart attack
• heart muscle disease or inflammation, such as hypertrophic cardiomyopathy or myocarditis
• abnormal heart valves
• diabetes
• birth abnormalities in the heart
• obesity
• obstructive sleep apnea

Although COPD may lead to CHF, CHF cannot directly cause COPD.

Smoking is by far the most common cause of COPD. However, nonsmokers can also get COPD, particularly if they have long-term exposure to environmental hazards, such as air pollution, dust, fumes, secondhand smoke, and chemicals.

In rare cases, an inherited condition that causes the deficiency of a protein called alpha-1 can lead to COPD.

Researchers have noted several links between COPD and CHF, pointing out that they share similar features, including:

• certain risk factors, such as smoking
• changes in how the lungs and heart function
• some signs and symptoms, such as shortness of breath and difficulty breathing
• both can make the other condition worse

Also, COPD can lead to CHF if the breathing issues that it causes place extra strain on the heart.

According to a 2018 journal paper, COPD and cardiovascular disease often occur together. The authors note that each condition can make the other one worse. They also say that the appropriate treatment of COPD can often have a positive effect on cardiovascular health, which may make it less likely that a person will develop CHF or another form of cardiovascular disease.

Other researchers recommend that healthcare teams monitor people with a diagnosis of one of these conditions for the presence of the other.

A 2018 study highlights the risk of healthcare professionals mistaking some of the signs and symptoms of CHF as belonging to COPD or another lung condition. The authors suggest that the common misclassification of the acute CHF presentation may be due to the overlap in the symptoms and risk factors of the conditions.

Another potentially confounding factor is that doctors may use the same tools to assess the conditions.

For example, a common test for COPD is to blow out air into an instrument known as a spirometer. The spirometer measures the volume of air that the lungs can release in a set number of seconds, known as the forced expiratory volume (FEV).

A key measurement is the FEV1 score, which measures the amount of air that the person blows out in 1 second. A doctor may believe that a low FEV1 score is due to COPD when it actually results from a CHF flare.

COPD encompasses three main obstructive lung diseases, all of which can cause blockages and reduced airflow: emphysema, chronic bronchitis, and asthma. COPD affects about 16 million people in the United States.

The possible symptoms of COPD include:

• wheezing
• fatigue
• chronic cough
• shortness of breath during normal activities
• blue tinge to the fingernails or lips
• excessive production of mucus or phlegm
• frequent respiratory infections

The treatment for COPD focuses on improving symptoms and slowing the progression of the disease. In some cases, a person may receive palliative care. Some common treatments include medication, surgery, oxygen therapy, pulmonary rehabilitation, and complementary therapies.

It may not be possible to prevent COPD in all cases. However, the National Heart, Lung, and Blood Institute states that the best way to reduce the risk is to stop or never start smoking. In addition, a person should avoid irritants, such as pollution, chemicals, and fumes, whenever possible.

Learn more about chronic obstructive pulmonary disease here.

The AHA explains that CHF causes a reduced rate of blood flow out of the heart, meaning that the heart is unable to meet the body’s oxygen demands. This impairment also results in a backup of blood in the venous circulation. Blood can pool in the blood vessels in the lungs, causing breathing trouble, and in other areas of the body, which can cause swelling.

The AHA also states that a person may experience symptoms such as:

• shortness of breath
• swelling
• persistent coughing or wheezing
• confusion and impaired thinking
• increased heart rate
• fatigue
• lack of appetite

According to the Centers for Disease Control and Prevention (CDC), treatment for CHF may involve one or more of the following:

• reducing fluid intake
• limiting sodium in the diet
• taking medication
• undergoing surgery
• engaging in regular exercise

A person can take steps to avoid CHF in the first place. These include:

• reaching or maintaining a moderate weight
• moderating alcohol intake
• getting regular exercise
• avoiding foods high in fat, sodium, and cholesterol
• quitting smoking, if a smoker, or avoiding secondhand smoke where possible

Learn more about congestive heart failure here.

A person should contact a doctor if they start to experience symptoms of either COPD or CHF and do not have a diagnosis. A doctor can review a person’s health history and test for either condition.

A person living with either condition should work with a doctor to manage their symptoms and ensure that the condition does not lead to other health issues.

COPD and CHF share several similarities, including some of the same symptoms and risk factors.

COPD can make CHF more likely, but CHF cannot directly cause COPD.

A person should talk with a doctor if they experience new respiratory symptoms, such as wheezing or trouble breathing.

A person can take steps to avoid both conditions by managing their weight, quitting smoking, and eating a nutritious, balanced diet.

Read this article in Spanish.