Victor Kim, MD: Could There be Another Reason for Breathlessness in COPD?

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Key opinion leaders at ATS 2023 urge physicians to treat more than just symptoms in patients with COPD and consider mood disorders and cardiac comorbidities.

The common practice of treating the respiratory symptoms of Chronic Obstructive Pulmonary Disease (COPD), such as breathlessness, was a frequent topic addressed at the American Thoracic Society (ATS) 2023 International Conference in Washington, DC, with key opinion leaders urging healthcare professionals to look beyond symptoms.

A session led by Victor Kim, MD, Professor, Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Director, Pulmonary Outpatient Clinic, Temple University Hospital, illuminated the prevalence of various comorbidities in individuals with COPD, with a focus on anxiety and depression.

“In routine visits sometimes it's hard as a pulmonologist or a specialist trying to see a patient with advanced lung disease,” Kim said, “they'll have breathlessness and that may be one of your primary tasks–you sort of deprioritize other mood disturbance in your focus with the patient.”

Other conditions can cause shortness of breath, like cardiac disease and even mood disorders, which he explained have been proven to coexist more frequently in patients with COPD and therefore, should be investigated.

“We as healthcare practitioners often focus on the most pressing issue and for some patients it’s their respiratory symptoms of breathlessness,” Kim said. “So when patients are diagnosed with COPD, they are getting respiratory medicines, but sometimes it's not always adequate in controlling the symptoms.”

Breathlessness can be a manifestation of cardiac disease or pulmonary disease, and it’s also a primary somatic symptom of depression or anxiety, which can create a symptomatic feedback loop.

“If you're always breathless, you might always be anxious just because it's anxiety-provoking–there is a relationship there,” he said. “Sometimes that makes screening for mood disorders much more difficult, because the symptoms that the patient may be complaining about may be a representation of a mood disorder."