Many, if not most, individuals with COPD have experienced a flare-up or worsening of shortness of breath and/or a productive cough. The medical word for a flare-up is an exacerbation. Generally, the causes of a flare-up include a respiratory infection, either viral or bacterial, and environmental - such as inhaling pollutants in the air. Other possible causes include heart disease, inflammation in the lungs, and psychologic factors - such as anxiety or a panic attack. Appropriate treatment requires the correct diagnosis.