Chronic Heart Disease Occurs Frequently in Those with COPD

Heart Disease and COPD – Shared Risk Factors

Study: A December 1, 2016, article in the American Journal of Respiratory and Critical Care Medicine (volume 194; pages 1319-1336) reviewed information about cardiac disease in those with COPD. (DOI: 10.1164/rccm.201604-0690SO) COPD and heart disease share risk factors that include:
  1. Older age
  2. Cigarette smoking
  3. Physical inactivity
  4. Low-grade inflammation in the body
Heart disease can occur in different parts of the heart.

Diagram of the heart

Heart disease is more common in those who have COPD (from 10 – 30%) compared with the adult population (about 1 – 2%). It contributes to the severity of COPD and is a common cause for hospitalization and death. Both heart disease and COPD can cause the same symptoms – shortness of breath and fatigue. The three most common heart diseases in those with COPD are:
  1. ischemic disease (narrowing of the arteries in the heart)
  2. heart failure (pumping action of the heart is impaired leading to fluid build-up in the lungs)
  3. atrial fibrillation (irregular heart rhythm).
Atrial fibrillation
Atrial fibrillation is a common heart disease in COPD

The curved arrows in the right and left atrium (upper chambers) in atrial fibrillation indicate chaotic electrical activity.

This is the most common heart rhythm problem in the general population as well as in those with COPD. The atria (two top chambers of the heart) beat irregularly AND the the ventricles (lower two chambers of the heart) do not work in sequence (together) with the atria. In those with stable COPD, atrial fibrillation occurs in 5 – 15%. In those with very severe COPD, it occurs in about 20 – 30%. Atrial fibrillation can cause shortness of breath, low energy, and a feeling of skipped heart beats. There is a risk for blood clots developing in the atria. Usually, anticoagulant medications (commonly called blood thinners) are recommended to reduce the risk of clots. What Can You Do? Certainly, you need to reduce risk factors for both heart and lung problems if possible. That means: do not smoke; be physically active; and do whatever possible to reduce inflammation in your body. I suggest that you view the October 17, 2016, post on my website under Frequently Asked Questions (FAQs). This post describes numerous foods that are anti-inflammatory and can boost the immune system. Finally, I encourage you to be proactive and ask your health care provider whether any shortness of breath or fatigue that you might experience could be due to a possible heart problem in addition to COPD.      

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.