Copd and heart attack

Keeping Your Heart Healthy With COPD

See your doctor about your COPD symptoms. Shortness of breath when you exert yourself could be caused by COPD or heart disease. Your doctor can perform several tests, including an echocardiogram, to evaluate the chambers of your heart and pumping strength, Santora explains. Your doctor also will test for a hormone called brain natriuretic peptide (BNP), which is often elevated in people with heart failure. Knowing the cause of your symptoms will help your doctor determine the most appropriate course of treatment for you.

Know your cholesterol and your blood pressure. These are key numbers for heart health. If these numbers are high, you can talk with your doctor about preventive treatments and what you can do to lower your numbers.

Manage your weight. When you have COPD, “it’s crucial to keep your weight down,” Santora says. “If you have a big belly, it can push up on your lungs, and the extra fat makes it harder for your heart to function.” It’s also important that you eat a heart-healthy diet that’s high in fruits, vegetables, and whole grains, and low in fats and sugars. Choose lean meats and low-fat dairy products, and prepare your foods by grilling or broiling rather than frying or dousing with rich sauces.

Exercise regularly. You need both aerobic exercise, such as walking or bicycling, and exercises that strengthen your upper body, Santora says. “Exercise is the best medicine for lung disease,” he says. “If you exercise, you keep your muscles in shape, and the heart is a muscle.” Talk to your doctor before starting an exercise program and together work out a routine that is safe for you.

Talk to your doctor about your medications. Doctors have long believed that some heart medicines, particularly beta blockers that slow the heart rate, aren’t safe for people who also have COPD. But a recent Dutch study by physicians at the University Medical Center Utrecht has indicated that fears about giving beta blockers to COPD patients may be unfounded. The researchers found that patients with COPD who were given beta blockers fared better than those who were not. Discuss your medications with your doctor to help determine what’s best for you.

Both COPD and heart disease can be serious and life-threatening, but if you make these important lifestyle changes, you will be able to stay more active and slow the progression of both conditions.

CIS Blog

You probably already know that heart disease is the leading cause of death in the United States. However, you may not realize that the third leading cause is chronic lower respiratory diseases, including chronic obstructive pulmonary disease (COPD). What’s more, you may not realize that the two are often connected, and that the symptoms they cause can be strikingly similar. Shortness of breath, for instance, is a hallmark sign that is often associated with both of these conditions.

Shortness of Breath from Heart Failure

Congestive heart failure (CHF) is a condition that occurs when the heart becomes too weak to effectively pump blood out to the rest of the body. In turn, fluid levels build up and blood can back up into both the heart and lungs, leading to shortness of breath. For most CHF patients, difficulty breathing does not occur when they are at rest, but even small amounts of exertion can cause symptoms to begin.

Shortness of Breath from COPD

Similarly to CHF patients, those with COPD will most commonly notice their shortness of breath when physically active. The conditions which cause COPD such as chronic bronchitis and emphysema result in irritation and damage to airways or the air sacs in the lungs where oxygen and carbon dioxide are exchanged. When someone with COPD exhales, this damage prevents oxygen from being fully released before the next breath is drawn in, resulting in shortness of breath.

Comorbidity of COPD and Heart Failure

COPD and congestive heart failure are two different conditions that may present with similar symptoms. However, there are two other forms of heart failure, left-sided and right-sided, which may be directly related to or exacerbated by the presence of COPD. Here’s how:

COPD and Left-Sided Heart Failure

There is not a direct connection between COPD and left-sided heart failure. However, the two conditions can exist together and exacerbate one another. COPD can cause low oxygen levels in the blood, thereby placing additional stress on the heart and worsening symptoms of left-sided heart failure. On the other hand, left-sided heart failure can contribute to fluid buildup in the lungs, aggravating the symptoms of COPD.

COPD and Right-Sided Heart Failure

In severe cases of COPD, the condition can actually cause the development of right-sided heart failure. This occurs when low oxygen levels due to COPD cause a rise in blood pressure in the arteries of the lungs, a condition known as pulmonary hypertension. This increase in pressure places excess strain on the heart’s right ventricle as it works to pump blood through the lungs. As a result, the heart muscle weakens and right-sided heart failure can occur.

COPD and heart failure are both dangerous health conditions, and while they often occur independently, it is also important to understand the connections between the two. If you have previously been diagnosed with COPD, you should be aware of the increased risk of heart failure. And, if you are a smoker, you need to understand that you are at a higher risk for developing both of these diseases. In any case, the medical expertise of a cardiologist should be sought in order to monitor existing conditions and help ensure heart health.

To get started with a cardiology physician, click below and request an appointment at any location of Cardiovascular Institute of the South.

Understanding COPD from a cardiovascular perspective

Some of the causes and symptoms of this common lung disease overlap with those of heart disease.

Published: May, 2018

Even though chronic obstructive pulmonary disease (COPD) is one of the nation’s leading causes of death, many people don’t know much about it. What’s more, they may mistakenly attribute COPD symptoms — such as trouble breathing, fatigue, and chest tightness during physical activity — to either heart disease or aging.

But recognizing this common condition is important, because treatment and lifestyle changes can help quite a bit, says Dr. Marilyn Moy, a pulmonologist at the VA Boston Healthcare System and associate professor of medicine at Harvard Medical School. “There is far more awareness about heart disease than COPD, so when people have breathing-related symptoms, they often assume it’s their heart,” she says. Because the breathing challenges caused by COPD appear gradually, people may overlook them or simply adjust their activities to them. People may notice they can’t walk as far as they used to, or do other things they enjoy, such as playing with their grandchildren or gardening, Dr. Moy says.

Symptoms of COPD

  • Shortness of breath, especially with activity

  • An ongoing cough or a cough that produces thick, stringy mucus (phlegm), which may be clear or yellowish

  • Frequent chest infections

  • Wheezing (a whistling, squeaky sound during breathing)

  • Chest tightness

Struggling to exhale

COPD includes two often-overlapping lung conditions: damage to the air sacs of the lungs (emphysema) and inflammation in the lung’s airways (bronchitis). The breathing issues and other hallmarks of the disease (see “Symptoms of COPD”) are not caused by problems getting air in, as many people believe. Instead, the problem is getting air out. Healthy lung tissue is similar to a rubber band — it springs back as you exhale. In COPD, that elasticity is destroyed, so the airways in the lungs close earlier than they should, leading to obstruction. “The inhaled air is trapped, and that’s what causes the breathlessness,” Dr. Moy explains. During physical activity, the breathing rate increases, creating even less time to exhale. The lungs overinflate, and symptoms worsen.

Smoking: A common thread

Heart disease and COPD often occur together. According to some estimates, people with COPD are more than twice as likely to have cardiovascular disease than the general public. Cigarette smoking, which ignites the cell-damaging process of inflammation, contributes to both diseases, but especially COPD. Smoking (both past and present) accounts for at least 80% of COPD cases.

Smoking rates have plummeted in recent decades. But in the mid-1960s — when the first wave of baby boomers were young adults — nearly half of men and about a third of women smoked cigarettes. The risk of COPD is highest among people who smoked at least a pack a day for at least 10 years. However, many heavy smokers do not develop COPD, and those who smoke less sometimes get the disease, suggesting that genetics and other factors are also at play.

Quitting smoking improves the health of your blood vessels within days. Your risk of heart disease and lung cancer drops substantially within five years. But the damage to your lung tissue is irreversible, says Dr. Moy. That’s why she advises current or former smokers (especially those with heart disease) to have a spirometry test.

Because around one in five people with COPD has never smoked, you should also ask about getting tested if you have COPD symptoms, live or have lived with a smoker, or have a family history of lung disease. There’s no downside to the test, which is quick, inexpensive, and painless, Dr. Moy says. It’s also helpful to have a baseline measurement, in case your lung function declines in the future.

Rehabilitation for your lungs

Inhaled drugs that relax the muscles around the airways, known as bronchodilators, are a mainstay of COPD therapy. Also, just as people with heart disease can benefit from cardiac rehabilitation, people with symptoms of COPD may benefit from pulmonary rehabilitation. The multifaceted program of aerobic exercise, strength training, and education helps patients manage their breathlessness and do everyday activities more easily.

Image: © Koldunova_Anna/Getty Images

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

COPD Doubles Risk for Fatal Heart Attack

About 735,000 Americans have a heart attack each year, and not all of them have heart disease.

For some, heart failure can strike without warning. When these unexpected heart attacks are fatal, it’s called sudden cardiac death (SCD), which claims as many as 250,000 lives in the United States every year.

A new study has concluded that a major risk factor for these killer heart attacks is chronic obstructive pulmonary disease (COPD), an ailment that damages the lungs and reduces their ability to exchange oxygen for carbon dioxide.

Existing studies have linked COPD with SCD among people with major heart problems, such as those who have experienced a heart attack or have needed heart surgery.

However, research published in the European Heart Journal found that even among people without such heart problems, people with COPD still have a substantially elevated risk for sudden cardiac death.

Learn More About Chronic Obstructive Pulmonary Disease (COPD) ”

He Needs Air, Doctor

Researchers examined data from 13,471 people over the age of 45, following them from 1990 to 2014. They found that after five years of living with COPD, patients had a twofold increase in their chances of experiencing SCD, even after the researchers took into account age, sex, and cigarette smoking. Among people with frequent complications from their COPD, such as coughing or shortness of breath, the risk increased threefold.

“This is the first study to show that COPD is associated with an increased risk of SCD in the general population and that this remains the case even when taking into account the fact that COPD is known to increase the risk of death from any cause,” explained Lies Lahousse, first author on the paper and post-doctoral researcher in respiratory medicine at Ghent University, Belgium, and the Erasmus Medical Center, Netherlands, in an interview with Healthline.

Although the exact nature of the connection between COPD and SCD isn’t yet fully understood, Lahousse pointed to some likely culprits. COPD and its complications can increase heart rate, cause systemic inflammation, and most importantly, progressively starve the heart of life-giving oxygen. As the lungs slowly fail, the available oxygen supply in the blood drops further and further, while poisonous carbon dioxide builds up. This weakens the heart and boosts the likelihood that it will spontaneously stop.

“I think this paper adds to the body of evidence that COPD, and likely the severity of the COPD and exacerbation frequency, have systemic effects that make the cardiac system more susceptible to SCD,” said Dr. Albert A. Rizzo, senior medical advisor to the American Lung Association and section chief of pulmonary/critical care medicine in the Christiana Care Health System, in an interview with Healthline. “This study may help raise the awareness of the importance of early diagnosis of COPD, both on the patient’s part as well as the health care provider.”

Read More: People with COPD Face Increased Heart Failure Risk ”

Get Diagnosed, Get Treated

Chronic lung disease, including COPD, is the third leading cause of death in the United States. About 13 million Americans have been diagnosed with COPD, although due to underdiagnosis, the actual number afflicted may be as high as 24 million.

Lahousse hopes that COPD will be added to the list of warning signs for SCD risk.

“Doctors should be aware of this increased risk of SCD in COPD patients, and should add COPD to other risk factors, including high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and a unhealthy lifestyle to optimize the individual risk stratification for cardiovascular screening,” she said. “If a patient with COPD has a high risk of SCD, preventive measures can be applied.”

“Once diagnosed, there can be more concerted efforts at improving lifestyles and the use of appropriate medications to help the COPD condition,” Rizzo explained. “These efforts should decrease the symptoms and decrease the rates of exacerbation and based on this study’s findings, decrease the risk of SCD.”

While medications like beta-blockers may help reduce the risk, Rizzo and Lahousse agree that quitting smoking is one of the most important ways that people with COPD can decrease their risk for SCD.

“Smoking cessation is paramount and participating in a form of regular exercise such as a formal pulmonary rehabilitation program is key to improve the quality of life of individuals with COPD,” concluded Rizzo.

Learn More: A Short Walk a Day Helps COPD Patients Stay Out of the Hospital ”

By Ed Edelson
HealthDay Reporter

WEDNESDAY, Jan. 20 (HealthDay News) — Heart and lung function appear to be intimately intertwined, so that even mild cases of chronic lung disease affect the heart’s ability to pump blood, a new study finds.

“It suggests that a larger subset of heart failure may be due to lung disease,” said Dr. R. Graham Barr, an assistant professor of medicine and epidemiology at Columbia University Medical Center and lead author of a report in the Jan. 21 issue of the New England Journal of Medicine.

It’s long been known that severe chronic obstructive pulmonary disease (COPD) can have damaging effects on the heart, Barr said. But the new report, which covered 2,816 people in a long-running lung study, shows that “even a mild decrease in lung function affects heart function,” he said.

Barr and his colleagues used two imaging techniques, computed tomography (CT) scanning and MRI, to measure both heart and lung structure and function. “We observed a linear straight-line relationship,” Barr said.

The probable cause of the loss of ability to pump blood, he said, is a reduced blood supply to the heart.

COPD is the fourth-leading cause of death in the United States. One form of COPD is emphysema, in which lung tissue is destroyed. Another form is chronic obstructive bronchitis, which causes narrowed airways, a persistent cough and excess mucus production. Lung disease is strongly associated with smoking.

The immediate application of the finding to medical practice would be in diagnosis, Barr said. “Our study was not of possible intervention,” he said. “Future studies will show how much treatment of the lung affects the heart and how much treatment of the heart affects the lung.”

Barr has begun such a study, which he said is in an early stage. “These problems take a long time to develop, and so they take a long time to study,” he said. The study is expected to last several years.

Meanwhile, physicians seeing people who report such lung problems as shortness of breath might consider testing their heart function, Barr said.

The report is an offshoot of a large study, supported by the U.S. National Heart, Lung and Blood Institute, that focused on finding early stages of heart, lung and blood diseases.

“What makes it a novel finding is that just a slight degree of lung disease can have an overall impact on cardiovascular health,” said James P. Kiley, director of the institute’s lung disease division. “What we are seeing here is the ability to bring the two conditions together.”

There is a distinct benefit in looking at the two conditions together, Kiley explained. “Understanding cardiovascular disease might help understand lung disease and vice versa,” he said. “We can put more emphasis on the possibility that these two do have a link and that the link needs to be explored further, even in the clinical assessment of a patient.”

Your Lungs and the Cardiovascular System

COPD affects your lungs, and it may also affect your heart. This is because your heart and lungs work together to send oxygen to the various cells of your body to keep you healthy. Today, we’re going to take you on a fun and educational ride through the cardiovascular system, which includes your blood vessels and heart. We promise to keep this an easy read for your educational enjoyment.

The heart can be affected by COPD

Your heart is a fist-sized organ that sits on the left side of your chest and is somewhat slanted to the left. It is a muscle that is responsible for pumping blood through your lungs and entire body. Your heart can be affected when you have a disease like COPD.

The air around us contains about 21% oxygen. Let’s take some fake eyes and place them on one oxygen molecule. We will now follow it as it travels through your body. It is inhaled, travels through your respiratory tract, to an air exchange unit called an alveoli.

Pulmonary capillaries

Once oxygen exits the alveoli and enters the bloodstream, it begins its journey in the pulmonary capillary system. As soon our oxygen molecule enters this stream it binds with a hemoglobin molecule. When this happens the blood turns bright red.

Pulmonary vein

Freshly oxygenated blood travels from the capillaries to the right or left pulmonary vein, and these deliver oxygen to the left atria of the heart.

Left Atria

Blood collects in this chamber momentarily until it is pumped through a valve called the bicuspid valve to the left ventricle. This and other valves of the heart are essential because they prevent blood from backing up. Our oxygen molecule travels smoothly from the lungs to left atria, and then to the…

Left Ventricle

This is the largest chamber of the heart. It is also the strongest. This is necessary because it is responsible for creating a large enough pressure for pumping blood through your entire body. A doctor can measure how hard it is working by taking a blood pressure. A high blood pressure means it is working too hard. Right now our person’s blood pressure is normal (120/80), and we follow our carbon dioxide molecule as it leaves the left ventricle through the Aortic Valve to the aorta.


The aorta is the largest artery. The arterial system contains freshly oxygenated blood from the lungs, and is therefore bright red. They carry oxygen molecules to all the cells of your body. By peering through our fake eyes, we go on a rollercoaster-like ride through a series of twists and turns to a…


Here, cellular metabolism takes place, and our oxygen molecule is used up to make energy so the cell can do its job. Our fake eyes pop off our oxygen molecule. A waste product of cellular metabolism is carbon dioxide. We will now place our fake eyes on a carbon dioxide molecule and continue with our journey. We watch as it travels through…


After oxygen leaves the bloodstream the blood turns a darker color, or a purplish-blue color. As soon as oxygen leaves a hemoglobin molecule, a carbon dioxide molecule attaches to it. We follow — by looking through our fake eyes — our molecule as it takes various twists and turns through veins to the right atria. If you look at your hands and arms, you can probably see some bluish veins. The best place to see them is the back of your wrist.

Right Atria

This is the smallest chamber of the heart. In the upper portion is a sinoatrial (SA) node, and this creates an electric charge responsible for the beating of your heart. Un-oxygenated blood travels from the right atria through the Tricuspid valve to the right ventricle.

Right Ventricle

This is smaller than the left ventricle. This is because only a light pressure is needed to push blood through the pulmonary valve to the pulmonary artery and to the lungs. Here, veins get smaller and smaller until we find ourselves in the…

Now we are back where we started, only in the unoxygenated side. As our carbon dioxide molecule approaches an alveoli, it crosses the alveolar-capillary membrane and into the alveoli.

Finishing the journey

Our carbon dioxide molecule is exhaled from the lungs into the atmosphere. Our ride is now complete. Please take your fake eyes off the molecule and return them to the receptacle to your right. You are free to keep any wisdom learned.

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