10 Signs You May Have a COPD Flare Up

by Erica Sanderson Editor

Chronic obstructive pulmonary disease (COPD) is a lifelong respiratory condition that usually refers to chronic bronchitis or emphysema. Sometimes symptoms can worsen due to various triggers or infection, causing a COPD exacerbation, or flare up. Keep an eye out for these signs that could indicate a flare up. Being proactive against exacerbations is important for maintaining good COPD control.


As airways tighten and narrow, exhaling becomes challenging. Escaping air through restricted airways often sounds like a whistling or crackling, better known as wheezing. You can usually hear this noise every time you exhale. It’s an early sign your lungs are congested and could lead to a flare up.

Blue fingertips

Blue fingernails or fingertips usually results from a lack of oxygen in the blood. This could mean your oxygen saturation level—the percentage of oxygen in the hemoglobin of red blood cells—is severely down. If your lung function is very low, red blood cells can’t acquire the proper amount of oxygen to circulate the body. You can regularly check your saturation levels at home with a pulse oximeter.

Mucus changes

Your mucus says a lot about you. Always inspect your mucus for changes associated with flare ups. Take note if your mucus appears darker, such as a greenish or brown color compared to the normal yellow shade. Increased mucus production and thicker mucus are also indicators of possible infection.


Fighting off infection is taxing on the body. COPD patients are usually a bit more tired than the average person. But if you’re constantly more exhausted than normal and simple tasks wipe you out, then something might be up.

Shortness of breath

Having trouble taking a deep breath? Your airways may be extra plugged up. Shortness of breath, or dyspnea, is a common symptom of a COPD flare up, particularly during exercise or movement. If you have supplemental oxygen, you may need to use it more frequently.


A fever is often a clear sign of infection. Your body increases its internal temperature as an immune defense to try and destroy excess bacteria. Higher temperatures are not conducive to viruses or bacteria, which are sensitive to hot and cold. Keep multiple thermometers in your house.

Chest pain

Chest pain can be caused by several reasons: violent coughing can pull muscles, the extra breathing effort can make you sore and it could also mean air isn’t exiting the airways properly. The inability to exhale is a serious complication. If you’re experiencing chest pain, call 911.


Neurological problems—confusion, headaches, dizziness—occur when the brain is not getting enough oxygen. This symptom often becomes more common as COPD progresses. However, it could also indicate a serious exacerbation.

Weight loss

Some COPD patients have trouble gaining or maintaining their weight. Try to step on the scale at least once per month. If you notice unexplained weight loss of several pounds or more, it could be that your body is fighting infection.

Swollen feet

The body may begin to retain fluid in the feet or ankles from heart problems. The heart and lungs work closely together. So if there’s a problem in one, there may be a problem in the other.

What to do

You may not experience all of these symptoms, although they often occur together during a flare up. If you’re experiencing any of these symptoms, call your pulmonologist as soon as possible. The quicker you jump on a flare up, the easier it will be to treat it. Always monitor and keep track of your symptoms. If you experience chest pain, severe neurological problems, or difficulty breathing, call 911.

Erica Sanderson
Meet Our Writer
Erica Sanderson

Erica Sanderson is a former content producer and editor for HealthCentral. Living with a chronic disorder that affects the lungs and instestine, Erica focused on covering digestive health and respiratory health. Topics included COPD, asthma, acid reflux, managing symptoms and medication.