Chronic obstructive pulmonary disease (
COPD) and
cardiovascular disease (CVD) frequently coexist, increasing the
prevalence of both entities and impacting on symptoms and
prognosis. CVD should be suspected in
patients with
COPD who have high/very high
risk scores on validated
scales, frequent exacerbations, precordial
pain, disproportionate
dyspnea, or palpitations. They should be referred to
cardiology if they have palpitations of unknown cause or angina
pain.
COPD should be suspected in
patients with CVD if they have recurrent
bronchitis,
cough and expectoration, or disproportionate
dyspnea. They should be referred to a
pulmonologist if they have
rhonchi or
wheezing,
air trapping,
emphysema, or signs of
chronic bronchitis.
Treatment of
COPD in cardiovascular
patients should include long-acting
muscarinic receptor antagonists (LAMA) or long-acting beta-
agonists (LABA) in low-
risk or high-
risk non-exacerbators, and LAMA/LABA/inhaled
corticosteroids in exacerbators
who are not controlled with
bronchodilators. Cardioselective beta-blockers should be favored in
patients with CVD, the long-term need for
amiodarone should be assessed, and
antiplatelet drugs should be maintained if indicated. (AU)