Box 4 Clinical notes IV: note of COPD exacerbations and cardiovascular events.

During exacerbation, patients with COPD and CVD may have manifestations of both diseases and cardiac events may combine with exacerbations of COPD

Exacerbations of COPD can be a trigger factor that causes arrhythmias, and, in turn, rhythm disturbances can cause COPD acute exacerbations

COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disease.