COPD and Heart Failure

“Justin has been admitted into the intensive care unit of the hospital, the doctor said he was having serious trouble breathing and his heart was failing as a result. I hope he survives this and stop smoking” Francesca said looking distraught and exhausted. 

Chronic obstructive pulmonary disease and heart failure are two different diseases but the former usually leads to the latter if not properly managed or controlled. 

What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory condition of the airways and lungs that result from long-term exposure to irritant gases, especially cigarette smoke. When cigarette smoke is inhaled for a long time, it causes the following progressive damage to the airways:

• Excess mucus production in the airways
• Damage to small hair-like structures that help to sweep irritants and particulate away from the airways
• Damage to structures that help the airways and the lungs to expand and retract
• Swelling of the lining of the airways

Ultimately, upon progressive damage to the above structures, respiration becomes difficult as the patient’s lungs can no longer breathe in enough air or even breath out enough carbon dioxide. This may lead to serious consequences if uncontrolled.

What is Heart Failure? 

Heart failure occurs when the heart can no longer pump sufficient amount of blood to meet the body’s needs. The heart and lungs work hand-in-hand in the following cycle:

• The heart first pumps blood rich in oxygen to all parts of the body
• After the tissues of the body extract oxygen and nutrients from blood, they release carbon-dioxide into it
• The tissues then send this blood back to the heart. 
• The heart pumps this “de-oxygenated” blood to the lungs to receive a fresh supply of oxygen and remove carbon-dioxide
• Then the lungs after exchanging carbon-dioxide for oxygen, send the “oxygenated” blood back to the heart
• Then the heart pumps the blood to all parts of the body again, starting the cycle.

So, if the lungs lose their function of gas exchange due to COPD, it will in no time affect the heart’s function. 

How does COPD affect the heart?

With severe COPD, the following problems can happen to the heart: 

• With low oxygen supply by the lungs due to COPD, the blood vessels delivering blood from the heart to the lungs become tense and constricted. This causes the pressure in the vessels to increase
• With this increased pressure in these blood vessels, the heart has to put more effort to pump blood to the lungs.
• Over time, this excessive effort weakens the heart, causing it to fail
   

When heart failure occurs in COPD, its symptoms are the same as with other causes of heart failure, and include: 

• Difficulty breathing
• Bluish lips and fingers
• Wheezing and coughing
• Swelling in the legs and belly area

Treatment of Heart Failure in COPD

If an individual with severe COPD develops heart failure, COPD treatments will be combined with heart failure treatment and these include:

• Bronchodilators: These medicines cause the airway and lungs to expand, causing them to take in more air.
• Supplemental oxygen: This is usually necessary as oxygen supply to the lungs and the rest of the body is severely compromised with COPD and heart failure
• Antibiotics: These help prevent chest infections, which could make the problem even worse
• Steroids: This improves breathing in COPD
• Mechanical ventilation in severe cases

COPD is a lung problem that results from long-term exposure to irritants, especially cigarette smoke. If not promptly controlled or managed, it may lead to the heart failing to pump enough blood to the body, increasing the risk of death.