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Chronic obstructive pulmonary disease (COPD) is an ongoing lung disease that makes it difficult to breathe. It’s also a disease that’s often misdiagnosed as asthma. Although most patients are correctly diagnosed by their doctors as having either asthma or COPD, up to 20% of patients with respiratory symptoms are difficult to accurately diagnose.
Because differentiating between asthma and COPD is essential for determining the appropriate treatment, understanding what sets these two lung diseases apart may help you decide whether or not you should further discuss your diagnosis with your doctor, or seek a second opinion.
COPD symptoms range from mild to very severe. Many people ignore early symptoms attributing them to smoking, being out of shape, or the aging process. As the disease progresses, however, many people develop most, if not all, of the following symptoms:
Like COPD, asthma symptoms can be minor to very severe. Because they vary from person to person, people with asthma may experience frequent, or infrequent, asthma attacks and/or symptoms, or they may have symptoms only at certain times (at night, during exercise). Signs and symptoms of asthma include:
Signs of worsening asthma are also important to recognize, and include asthma symptoms that are troublesome and more frequent, worsening shortness of breath, and the need to use a relief, or rescue, inhaler more frequently.
Because asthma and COPD share similar symptoms, it’s often difficult to differentiate between the two, even for health care providers. To better understand your symptoms, ask yourself the following questions and then discuss the answers with your doctor:
While asthma can occur at any age, the onset of COPD generally occurs sometime after 45 to 50 years of age.
Approximately 80-90% of those diagnosed with COPD are current or former smokers. In contrast, many non-smokers get asthma.
Stress, weather changes, environmental allergens and pollutants, even perfume, can trigger an asthma attack. For these patients, avoiding the trigger usually prevents the attack. In COPD, steering clear of airway irritants like tobacco smoke or air pollution does little to improve COPD symptoms.
It’s normal for many people with asthma to be symptom-free between asthma attacks. It’s rare that people with COPD go a day without symptoms, even when they’re not having an exacerbation (attack of worsening symptoms).
Generally, appropriate treatment will completely reverse an asthma attack, returning lung function to normal. In contrast, medication is only partially effective at reversing the airway obstruction in COPD.
After reading this article, we hope that you’re better prepared to discuss your respiratory symptoms with your doctor so that he or she can make an accurate diagnosis. Talk to your doctor today for more information about the difference between asthma and COPD.
 Miravittles, Mark, et. al. “Difficulties in differential diagnosis of COPD and asthma in primary care.” Br J Gen Pract. 2012 Feb; 62(595): e68–e75. Published online 2012 Jan 30. doi: 10.3399/bjgp12X625111 PMCID: PMC3268496.
 “What are the signs and symptoms of COPD?” American Thoracic Society. Accessed online February 25, 2015.
 “Asthma: Symptoms”. Mayo Clinic. Accessed online on February 25, 2015.
 Rodrigo Athanazio. “Airway disease: similarities and differences between asthma, COPD and bronchiectasis.” Clinics (Sao Paulo). 2012 Nov; 67(11): 1335–1343. doi: 10.6061/clinics/2012(11)19 PMCID: PMC3488995.
by Deborah Leader RN, BSN, PHN