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Complications of Asthma vs. Complications of COPD

Both asthma and COPD can sometimes flare-up. This is often referred to as asthma or COPD exacerbations. With asthma, these episodes are usually referred to as asthma attacks. With COPD these are usually referred to as COPD flare-ups. So, here are some differences between asthma attacks and COPD flare-ups.

Asthma attacks

Asthma affects the bronchial airways. These are your smallest airways. A key feature of asthma is these airways are chronically inflamed. This makes them hypersensitive or overly sensitive. This means they are twitchy when exposed to asthma triggers.1,2

So, let’s say you have asthma and your asthma trigger is dust mites. So, you’re cleaning a closet and inhale lots of dust mites. This causes your immune system to respond. A series of chemical reactions occur in response to dust mites. This causes airway inflammation to get worse.

So, this worsening airway inflammation irritates airway cells. Smooth muscles are wrapped around these airways. These muscles spasm and constrict to squeeze airways. This is called bronchospasm or bronchoconstriction. This causes airways to become narrow. This obstructs the flow of air through them.2

This worsening inflammation also irritates mucus producing cells and glands. These secrete extra mucus. This mucus can collect in airways to further obstruct them.3 A combination of these effects can make you feel short of breath and have chest tightness. It can make you cough. It can make you wheeze.3

Asthma attacks may be experienced differently from one asthmatic to another. Asthma attacks may also vary in intensity and severity over time. However, a key feature of asthma is that asthma attacks are reversible. This can be accomplished by removing yourself from the trigger, by resting, or by taking asthma medicines.3

Another key feature of asthma is that it’s controllable. This means that asthma attacks can be prevented and made mild and easy to control when they do occur. Good asthma control means breathing should be normal between attacks.4

Most of these attacks can be managed at home. For this reason, asthmatics are encouraged to work with their doctors on creating an asthma management program. This may entail both taking medicines and controlling potential asthma triggers. However, some asthma attacks may be severe and life-threatening and require immediate medical intervention.3,4

Asthmatics are also encouraged to create asthma management plans. These list what to do daily to control symptoms along with what to do when symptoms are felt. This may involve tweaking their asthma management plan. It may also entail seeking medical attention.3,4

COPD flare-ups

Bronchial airways in COPD are also chronically inflamed. This inflammation may result in airway scarring. This makes airways chronically narrowed. COPD airways are also replete with extra glands and cells that produce mucus. So, excessive mucus production is also a common feature of COPD. Both of these features may cause people with COPD to experience some symptoms every day.5,6

Airways are generally kept sterile. Excessive mucus production may create a nice breeding ground for respiratory infections. So, this makes people with COPD at an increased risk for developing respiratory infections, such as pneumonia. These infections are one of the main causes of COPD flare-ups.5

Like asthma, their inflamed airway may also be hypersensitive. So, like asthma, bronchospasm may occur in response to triggers such as common allergens, strong smells, cigarette smoke, wood smoke, etc. The likelihood of this happening is increased if the person also has asthma.2

The heart may also be affected by COPD. It may fatigue due to working too hard to pump blood through diseased lungs. This may cause a condition called heart failure. When this happens fluid may back up into the lungs.5

Some people with COPD experience no daily symptoms. Although, many people with COPD experience some symptoms every day. Most of these can be managed at home. COPD flare-ups may be severe and life-threatening, requiring immediate intervention. So patients must be properly educated about flare-ups and what to do when they occur.

Like asthmatics, COPD doctors are encouraged to work with their patients on creating COPD management plans. These show what to do daily to manage symptoms. They also help guide actions when new or worsening symptoms appear. Such actions may include tweaking the medicine regimen, calling their doctor, or calling 911.

What to make of this?

So, both COPD and asthma may flare-up from time to time. The goal of any asthma treatment regimen is to control asthma and prevent asthma attacks. The goal of any COPD treatment regimen is to minimize symptoms and prevent COPD flare-ups.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. “What Is Asthma: Chapter One: The Harvard Medical School Guide To Taking Control Of Asthma,” Asthma Center: Partners Healthcare,, accessed 4/17/19
  2. “Asthma Attack,” American College of Allergy & Immunology,, accessed 4/17/19
  3. Global Strategy for Asthma Management And Prevention (Asthma Guidelines), Global Initiative For Asthma (GINA), 2018, file:///home/chronos/u-e6d2a5f30608774b97459078c60617702497a161/Downloads/wms-GINA-2018-report-V1.3-002.pdf, accessed 4/12/19, page 14, 31-32, 75-78
  4. Guidelines For The Diagnosis And Management Of Asthma, NHLBI, Summary Report, 2007,, accessed 4/17/19, pages 15-21
  5. Weinberger, Steven E., Barbara A. Cockrill, Jess Mandel, “Principles Of Pulmonary Medicine,” 2014, Elsevier, pages 75, 103
  6. COPD Guidelines. Global Initiative For Chronic Obstructive Lung Disease (GOLD), 2018,, accessed 4/12/19


  • JanetH
    7 months ago

    When I last visited my allergist’s office (last week) for an on-going infection, they did a spirometry, the 3rd or 4th in the past six months. Apparently the last two show a reduction compared to the one done in January. I asked her if she was considering I might have something else, such as COPD, and she said yes. She said the scores are not in the zone of worrying, and my blood oxygen level is good. But, the results keep going down a bit each time, and she said that’s a concerning trend.

  • Leon Lebowitz, RRT moderator
    7 months ago

    Hi JanetH and thanks for this post. I can understand your concern as it looks like (as you’ve said), there appears to be a trend in your test results. The physician may advise you you’re not in the ‘worry zone’ yet, but you still may want to discuss this further as to what her treatment strategy (for you) will be. What do you think? Leon (site moderator)

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