COPD GUIDE

COPD Symptoms: From Early Signs to the Advanced Stage

Prof. Dr. Yalçın Karakoca · Last updated: 25 September 2026

SHORT ANSWER

The most common symptom of COPD is shortness of breath that gets worse with exertion. A cough that lasts for weeks and phlegm, especially in the mornings, are also common. Wheezing and tiring quickly also occur. The early symptoms are often put down to ageing or a lack of fitness. This is why the diagnosis is delayed. As the disease progresses, shortness of breath can also occur at rest. Frequent infections, low oxygen levels and weight loss can also occur. Anyone who has smoked and has these symptoms should have a breathing test (spirometry).

Early symptoms (often overlooked)

Getting out of breath on stairs or hills more quickly than before
A cough with phlegm in the mornings, known as “smoker’s cough”
Bronchitis that lasts a long time every winter
Slowing down when walking, falling behind people of your age
Wheezing, chest tightness

Getting a diagnosis at this point is important. Stopping smoking and starting treatment markedly slow the loss of lung function.

Symptoms in the moderate and advanced stages

Symptom	Cause
Needing to stop when walking on level ground, shortness of breath when getting dressed	Narrowing of the airways and air building up in the lungs
Shortness of breath at rest	Advanced narrowing, air build-up and low oxygen levels
Frequent flare-ups (two or more a year) or hospital admission because of a flare-up	Infections, polluted air; inflammation in the airways
Lips and fingertips turning blue	A drop in the oxygen level in the blood
Morning headache, daytime sleepiness	A rise in carbon dioxide in the blood
Loss of weight and muscle	More energy spent on breathing, inflammation in the body
Swelling of the ankles	Strain on the right side of the heart
Depression, anxiety	The burden of a long-term illness

The type of symptoms guides treatment

In chronic bronchitis-type COPD, cough and phlegm predominate. In these patients, techniques for clearing phlegm are important. If symptoms persist despite medicines and these techniques, balloon treatment may be considered. In emphysema-type COPD, by contrast, shortness of breath and air building up in the lungs predominate. In these patients, options aimed at reducing lung volume, such as a lung valve, are considered.

Emergency symptoms — 112

Call 112 immediately in these situations:

Shortness of breath that stops you from talking
Turning blue or becoming confused
Chest pain
Shortness of breath that gets worse quickly, with a fever
Your oxygen reading dropping well below your usual level

PRELIMINARY ASSESSMENT

Is it suitable for you?

Book an appointment and bring your breathing test and chest CT scan reports. We decide together at the consultation. If you are coming from outside Istanbul, an online preliminary consultation can be held first.

Please bring: your breathing test, your chest CT scan report and images (CD/USB), your list of medicines and, if you have one, your blood gas test result.

HAVE A QUESTION?

Frequently asked questions

The questions our patients and their relatives ask most often, with answers. We discuss questions about your own situation together at the consultation.

Do COPD symptoms appear suddenly?

They usually develop slowly over the years. During a flare-up, however, they can get worse within a few days.

What are the final symptoms of COPD?

There may be shortness of breath even at rest and a constant need for oxygen. Frequent hospital admissions, weight loss and swelling in the feet may also occur. Details: End-stage COPD.

Can non-smokers get it too?

Yes.

Does COPD show up on a chest X-ray?

Some changes may be visible, but a normal X-ray does not rule out COPD. A breathing test is needed for the diagnosis.

What does the colour of your phlegm mean?

Thick, yellow-green phlegm may be a sign of an infection or a flare-up. If there is blood in your phlegm, be sure to see a doctor.

APPOINTMENT

Book an appointment for a preliminary assessment

To find out whether you are suitable, book a preliminary assessment appointment. Bring your breathing test, chest CT scan report and list of medicines with you.

info@yalcinkarakoca.com · Rüzgarlıbahçe Mah. Cumhuriyet Cad. Hasoğlu Plaza Kat:3, Kavacık / Beykoz, İstanbul

REFERENCES

International COPD guideline (GOLD 2026 report); Turkish Thoracic Society COPD Diagnosis and Treatment Consensus Report.

This page is for general information purposes. It does not replace a medical examination or diagnosis. Treatment decisions are made during an examination, on an individual basis. In an emergency, call 112.

Medical content review: Prof. Dr. Yalçın Karakoca, Pulmonologist · Last updated: 25 September 2026

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