Did you know that about half of those with COPD will develop cardiovascular disease in their lifetimes? Both are serious conditions that can cause shortness of breath and difficulty exercising, and can lead to other complications. Read on to find out more about the connection between COPD and heart disease and find ways to learn about early detection methods.

Lung disease is serious. Heart disease is serious. But the combination is double trouble!

Let’s start at the beginning. Heart disease is common. It is the number one killer of men and women in the United States, usually as the result of a blockage in the blood vessels that supply the heart (coronary artery disease) and produces heart attacks (myocardial infarctions). The symptoms of a heart attack may seem obvious if you’ve ever watched a scripted TV medical drama, but the reality is that chest pain does not always occur. Instead, shortness of breath, nausea, dizziness, or arm pain, alone or in combination, are relatively common. Unusual symptoms other than chest pain occur more often in women than in men.

So, if you are short of breath during exercise from COPD, how do you know if it is lung disease, or heart disease, or both? It may be difficult to distinguish which condition is driving your symptoms, both for you and your healthcare providers. The symptoms of both diseases can worsen with exercise. Both diseases are more likely to occur in those with a history of smoking cigarettes. And both diseases cause shortness of breath. In fact, about half of patients with COPD get heart disease at some time in their life.

The reason that patients with COPD are at higher risk for heart disease is complicated. Lower oxygen levels, higher blood levels of inflammatory proteins from the lungs, and more stress on the heart muscle with exercise are all factors involved. This is why healthcare teams will sometimes send a COPD patient for heart disease screening. Some centers require screening before beginning an exercise program such as pulmonary rehabilitation.

Screening for heart disease usually involves at least three tests. The first test is the electrocardiogram (EKG), an electrical tracing that can show past or current heart attacks and is easy to perform.

The second test is an echocardiogram (ECHO), a sound wave test that allows the heart muscle to be visualized while it is beating. Leaky valves, past heart attacks, and congestive heart failure are diagnosed with this test.

The third test that is often performed is a stress test. During a stress test, the goal is to measure how well the heart functions when challenged to work harder than normal. Ancillary tests done with cardiac stimulation include an ECHO or nuclear medicine imaging that can be more accurate in detecting heart disease problems.
If these screening tests are suggestive, then cardiac catheterization is sometimes done. Increasingly, heart catheterization can be done by passing a thin, flexible tube through a wrist blood vessel to the heart to show blocked or restricted arteries. Newer CT tests to look at the heart for calcium in the coronary arteries or with dye to evaluate blockages are sometimes done.

At the end of the day, most heart specialists will keep the patient under their care if heart disease is found. If no heart disease is found, the patient is returned to primary care or to pulmonary care.

Because having COPD is overwhelming by itself, it can be difficult to stay abreast of other potential health problems such as cardiovascular disease. However, knowing the connection between the two conditions can lead to lifestyle changes and preventive measures that improve your symptoms.