Cardiac Involvement in Chronic Obstructive Pulmonary Disease: Findings from a Hospital-Based Observational Study

Background: Chronic obstructive pulmonary disease (COPD) is a leading global cause of morbidity and mortality, especially in low- and middle-income countries. It is characterized by chronic airflow limitation and exacerbations, with cardiac comorbidities significantly affecting disease severity and outcomes. This study aims to evaluate the cardiological manifestations of COPD patients presenting with acute exacerbations in a tertiary care hospital.

Methods: This hospital-based observational study included 145 adults with confirmed COPD presenting with acute exacerbations, in whom demographic details, smoking status, clinical features, chest X-ray findings, electrocardiographic and echocardiographic parameters were assessed.

Results: Most patients were elderly (>60 years, 70.4%), female (58.6%), and from rural areas (78.6%), with smoking exposure in 71.7% and disease duration >10 years in 64.9%. Breathlessness was universal, followed by cough (58.6%). Chest X-ray commonly showed a tubular heart shadow (52.4%) and features of hyperinflation. ECG abnormalities were frequent, particularly first-degree AV block (16.6%) and atrial changes. Echocardiography showed preserved mean ejection fraction (56.5 ± 4.1%) with predominant right-sided involvement, including dilated RA/RV (40.7%), diastolic dysfunction (46.2%), moderate tricuspid regurgitation (45.5%), and pulmonary hypertension (41.4%).

Conclusion: COPD patients with acute exacerbations frequently have significant cardiac involvement and characteristic radiologic features. Routine echocardiographic assessment and guideline‑based management lead to improved clinical outcomes.