Chronic Obstructive Pulmonary Disease (COPD)

Diagnosis

Your doctor will examine you, looking for evidence of COPD by checking for rapid breathing; a bluish tint to your skin, lips or fingernails; a distended, barrel-shaped chest; use of neck muscles to breathe; abnormal breath sounds; and signs of heart failure, especially swelling in the ankle and legs.

To confirm the diagnosis, he or she may order the following tests:

• Pulmonary function test - In this test, you will breathe into a special mouthpiece, and a machine will take measurements to test how much your airways are blocked and how much your lungs inflate.

• Blood tests - Blood tests measure the different types of blood cells or the amount of oxygen and carbon dioxide in the blood. Others are used to check for low alpha-1-antitrypsin levels, especially in a nonsmoker who shows symptoms of emphysema.

• Chest X-rays - These help to rule out pneumonia and lung cancer, and they also show heart size. If you have emphysema, chest X-rays can pinpoint areas where lung tissue has been destroyed.

• Electrocardiogram - This test measures the electric activity of the heart and usually is done to make sure your symptoms are not caused by a heart problem.

• Sputum analysis - A small amount of mucus is collected and tested for respiratory infection.

• Exercise stress test - In this test, you walk on a treadmill while a specialist monitors the intensity of your exercise. This test looks for any signs of coronary artery disease.

If you are diagnosed with the inherited form of emphysema, family members, including children, also should be tested to determine if they have a deficiency of alpha-1-antitrypsin.

Expected Duration

Symptoms of chronic bronchitis tend to begin in smokers after age 50. These symptoms persist and gradually worsen for the rest of the smoker's life unless he or she quits smoking.

Most cases of emphysema are diagnosed in smokers in their 50s or 60s. People with the inherited form of emphysema can show symptoms as early as age 30. Regardless of the cause, emphysema has no cure and lasts a lifetime.