10 Ways COPD Affects the Heart

by John Bottrell Health Professional

Your heart and lungs work together as a team to oxygenate your body. So it only makes sense that a disease like chronic obstructive pulmonary disease (COPD) that affects the lungs might also, over time, affect the heart too.

In order to understand how a particular lung disease might affect the heart, it's important to have a good understanding of lung and heart anatomy. For this reason you may want to read how chronic bronchitis affects the lungs and how the heart and lungs work together.

As a refresher, here are some basics to know:

Your heart is a muscle

Like other muscles of your body, when overworked it becomes enlarged (hypertrophic). When this happens to your biceps it may be a sign of good health. However, when this happens to your heart it's not so good, and means your heart is working too hard.

Your heart has two working sides

The right side of the heart generates pressure to pump oxygenated blood through the lungs, and the left side of the heart (left ventricle) generates a strong pressure to pump blood through the rest of your body.

How does a lung condition like COPD affect your heart?

Poor ventilation

As COPD progresses, loss of lung tissue and obstructed airways creates poorly ventilated areas inside your lungs, or areas that receive little or no oxygen. Studies show that supplemental oxygen does not appear to solve this problem because oxygen simply cannot get to these poorly ventilated areas.

Pulmonary vasoconstriction

In the areas of poor ventilation, your body is tricked into thinking it can fix the problem by constricting pulmonary blood vessels, making the blood move faster in order to access more oxygen.

Pulmonary hypertension

Vasoconstriction causes the right heart to pump harder and faster in order to do its job, raising the blood pressure inside the lungs.

Cor pulmonale

After years of working hard to pump blood through diseased lungs, the right heart side of the heart increases in size, a condition known as cor pulmonale. When this occurs, it is generally considered to herald the end stages of COPD. Learn more about cor pulmonale.

Right-sided heart failure

Cor pulmonale makes the right side of the heart a weaker pump system, and over time it may simply become tired and inefficient at pumpming, causing blood to pool inside it.

Left-sided heart failure

Since the right heart pumps blood through the lungs and to the left side of the heart, right heart failure may ultimately lead to left-sided heart failure. The heart is now unable to keep up with the demands of the body and begins to fail. Learn more about congested heart failure.

Peripheral edema

When the left side of the heart is unable to effectively pump blood through the entire body, blood may pool in the legs, feet and ankles. This is an early sign of heart failure. If you have heart disease and begin to notice these symptoms, you should seek medical attention. This may also be a sign of chronic (meaning it's always there) heart failure. It is usually reversible.

Pulmonary edema

With a weak pump, and constricted pulmonary vessels, pulmonary blood pressure may increase to the point that blood (fluid) seeps into lung tissue. This fluid seepage condition is called pulmonary edema, and may make breathing increasingly difficult. This is a sign of acute (meaning it's happening now) heart failure. You must seek immediate medical attention (call 911).


Dyspnea is an ancient Greek term often used to describe shortness of breath, difficulty breathing, or air hunger. Orthopnea is another Greek term meaning your breathing is so difficult you have to sit up to breathe. This can be a sign of congestive heart failure. Again, if you note these changes suddenly or if they increase daily, you must seek immediate medical attention (call 911).

Atrial fibrillation

This is the most common abnormal heartbeat (arrhythmia) that may occur when the heart is working harder. This basically means that your heart fibrillates, causing a slow, rapid, or irregular heartbeat. It can be acute or chronic, but it does require medical evaluation. It may present with chest pain or dyspnea, or it may present with no symptoms at all. This heart arrhythmia increases your risk of heart failure and stroke. Patients with this arrythmia require blood thinners.

Bottom line

It’s clear that poorly functioning lungs or 'sick' lungs may lead to a poorly functioning 'sick' heart. These ten situations are potential conditions that could occur if you have COPD, but it doesn't mean they will happen. COPD progression can be slowed by stopping smoking and working with your physician to make necessary lifestyle changes. Work with your health team so you can live an active life wth COPD and minimize or delay some of the cardiac complications that can potentially occur.

John Bottrell
Meet Our Writer
John Bottrell

John Bottrell is a registered Respiratory Therapist. He wrote for HealthCentral as a health professional for Asthma and Chronic Obstructive Pulmonary Disease (COPD).