Table of Contents
Diagnostic Tests
Despite the widespread incidence and seriousness of COPD, studies strongly suggest that it is underdiagnosed, especially in women. Some experts recommend that any adult smoker who complains of a daily cough should be screened for COPD. In one study, nearly half of patients over age 60 who regularly smoked had COPD. Anyone who has a chronic cough, increased phlegm production, or breathing difficulty that gets worse over time should be checked for the disease.
Medical and Personal History
The doctor will request a history that evaluates the patient's risk factors. Risk factors include:
- Past and present smoking
- Exposure to industrial pollutants at work
- Family history of alpha-1 antitrypsin deficiency
- Low exercise capacity (such as trouble climbing stairs or difficulty walking for more than a certain distance)
- Past and present smoking
Physical Examination
Appearance. There are usually no changes in physical appearance in people with mild-to-moderate COPD. In advanced COPD, patients with emphysema may be wasted and thin, with normal-colored pink skin. Those with chronic bronchitis may have bluish lips and fingers, be obese, and may have swollen feet and legs. Breathing may be rapid and shallow, done through pursed lips, and it may take longer to breathe out.
The patient will be asked to cough and produce phlegm, if possible.
Chest Examination. The physician will next perform a simple examination of the chest area with a stethoscope to listen for:
- Crepitations, a noise resembling a paper bag being rumpled
- Reduced or distant breath sounds
- Signs of pulmonary hypertension
- Wheezing or gurgling sounds
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Review Date: 04/10/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
