What Causes Difficulty Breathing When Diagnosed With COPD Of A Smoker?

Posted on Thu, 24 Sep 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 24 Sep 2015 Answered on

Fri, 16 Oct 2015 Last reviewed on

Question : My mother is 77 years old (11/17/1937 birth date), she has been diagnosed with COPD and still smokes 1-2 packs a day. All her vitals are good and in range. Her 02 levels are good, yet she has frequent periods of not being able to breathe and feels like she's dying. Lately she has had pain in her sternum area and under the breasts. Her legs, feet, and hands swell. Could these be symptoms of a blood clot? and if so, why are her vitals and o2 levels still within normal range?

Answered by Dr. Prof. Kunal Saha (2 hours later)

Brief Answer:
These are not likely to be symptoms of blood clot.

Detailed Answer:
Thanks for asking on HealthcareMagic.

In COPD smoking damages the lung and the exchange of oxygen between the alveoli (the small air sacs of the lung) and the arterial blood is not proper. Even though a pulse oxymeter might give a SPO2 reading of 98% that does not mean that the partial pressure of oxygen in the artery (PaO2) is high. The latter is measured by arterial blood gas analysis and if you get the arterial blood gas analyzed, you will know that there is inadequate amount of oxygen mixed in the watery or plasma portion of the blood even though the oxygen loaded on the hemoglobin might be ok. That is the reason of her breathlessness and other problems.

Although a heart attack due to a blood clot can present with similar complaints, I am quite sure that in her case these symptoms are not due to a blood clot but rather due to her COPD.

Reading the following will help you understand the concepts better:
http://dwb4.unl.edu/Chem/CHEM869V/CHEM869VLinks/www.mtsinai.org/pulmonary/ABG/PO2.htm

Hope that helps.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prof. Kunal Saha (9 hours later)

What area of the body do they normally retrieve blood gases? My mother is extremely mal-nourished and then.

Answered by Dr. Prof. Kunal Saha (4 hours later)

Brief Answer:
The oxygen exchange occurs from lining of the air sacs of the lung

Detailed Answer:
The oxygen exchange is not from the body surface area. It is from the total surface area of the membranous lining of the alveoli or the air sacs inside the lung. The malnourishment is not causing poor oxygen exchange. Rather, it could be a result of the cells not getting adequate oxygen which is more likely to be happening due to her COPD.

She definitely needs to give up on smoking.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar