What Is a COPD Exacerbation Flare, and What Are Its Symptoms?

A fellow caregiver asked...

What's a COPD exacerbation flare ("flare-up"), and what are the signs of a flare?

Expert Answer

Dr. Leslie Kernisan is the author of a popular blog and podcast at BetterHealthWhileAging.net. She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

A chronic obstructive pulmonary disease (COPD) exacerbation flare is an increase in the usual severity of symptoms of COPD.

The signs of a flare-up are a worsening of whatever the person's usual COPD symptoms are. These may include:

  • An increase in frequency and severity of coughing.
  • Increased production of phlegm (sputum or mucus) when coughing.
  • A change in the appearance of the phlegm.
  • Increased shortness of breath.

One should always seek prompt medical evaluation for signs of a COPD exacerbation flare. Without treatment, people may experience life-threatening breathing problems. If someone with COPD seems extremely short of breath or passes out, call 911 right away.

Some COPD exacerbations require treatment in the hospital for a few days, while others can be safely treated in an outpatient setting. In severe cases, people with COPD exacerbations may need to be on a ventilator, or breathing machine, until their flare-up resolves.

More than half of exacerbation flares are caused by an infection in the lungs or airways, either viral or bacterial. Another 10 percent are triggered by air pollution. In 30 to 40 percent of cases, though, the cause can't be pinpointed.

In addition, many other conditions affecting the heart and lungs share the symptoms of a COPD exacerbation flare. These include heart attacks, blood clots in the lungs, or heart failure. That's another reason it's always important to get an evaluation when anyone's COPD symptoms seem acutely worse.