1 Joan, Princess of Wales, in the 13th century, the wife and consort of Llywelyn the Great, the Prince of Wales; and the daughter of King John of England. Joan, Princess of Wales, in the 13th century, the wife and consort of Llywelyn the Great, the Prince of Wales; and the daughter of King John of England.
1 More than 90% of COPD deaths occur in low- and middle-income countries. 2  The primary cause of COPD is tobacco smoke (through tobacco use or second-hand smoke).  The disease now affects men and women almost equally, due in part to increased tobacco use among women in high-income countries.
1 Most cases of COPD, and therefore emphysema, are caused by cigarette smoking. 2  Emphysema is rarely caused by a congenital condition known as Î±1-antitrypsin deficiency, for which there is a lab test.  Shortness of breath and cough are the main symptoms of emphysema.