Is it COPD, Asthma or Pneumonia? How Can You Tell?

by Jane Martin Health Professional

How does your doctor go about figuring out what is wrong with you and arrive at the correct diagnosis? Let's begin with a story, something that happened to me not long ago...

"Well, it's one of three things," said the doctor. It could be caused by a medication, it could be Adie Syndrome, which could go away anytime or you might have it forever"or it could be a brain aneurysm."_

I lost it, broke down and cried, right there in front of the doctor and the nurse. The doc patted me on the shoulder and handed me a tissue. "We'll figure it out. Stay right there, we'll try the eye drops and see if that helps."

I'd just returned from a wonderful vacation, my first time ever on a cruise. As we were heading home, my left pupil, the middle, black part of my eye became huge. That's what brought me in to see the opthomologist that morning.

They say it's not necessarily what your doctor says - but what you hear - that you remember and dwell upon. I worked with very sick patients for over 20 years, at the bedside when doctors gave patients and their families a diagnosis and prognosis. I was surprised when quite often the family had a totally different take on the conversation than what the doc had intended. But, I was the patient now - on the other side of the bed - and forgetting everything I'd heard but the third possibility, the worst one. I was a wreck. This was confusing.
What was going on with my eye, and what would happen to me?

So, how does your doctor go about figuring out what is wrong with you and arrive at the correct diagnosis? And how does he or she know for sure what isn't the problem, that you don't have a certain diagnosis?

In these two shareposts we're going to look at lung conditions our readers have asked about, those that could be mistaken for COPD. We'll also look at some methods and medical tests commonly used to find a correct diagnosis. Note: Your doctor might not require all these tests or he / she may order others.

COPD vs. Asthma

Asthma is an inflammatory disease of the airways of the lung, which produces narrowing or constriction. Although COPD and asthma have similar characteristics such as coughing and wheezing, they are two different conditions.

The main difference is that asthma is completely reversible. With treatment, a person with asthma can have near-normal lung function and be free of symptoms between episodes / flare-ups. Asthma episodes with wheezing, shortness of breath, chest tightness and cough often have triggers that can be identified easily. These triggers can be caused by seasonal or other allergens, airborne irritants such as smoke or dust, cold air or exercise.

COPD, on the other hand, is also characterized by airflow obstruction, but it is not completely reversible. Some people with COPD have partial reversibility but they don't usually don't experience the same level of improvement as people with asthma.

Although episodes /flare-ups, (exacerbations) in COPD patients can be brought on by irritants in the air, they are commonly caused by a bacteria or virus in the respiratory tract.

It is sometimes thought that an easy way to tell the difference between COPD and asthma is the age when a diagnosis is made - that asthma is most often diagnosed in childhood or adolescence, while COPD is diagnosed later in life. But this is not always the case. It's very common for the genetically inherited cause of COPD, Alpha-1 Antitrypsin Deficiency, to be mistaken for asthma in a younger person.

Methods and Tests for Diagnosis for COPD and Asthma
Health history, listening to lung sounds, Complete Pulmonary Function test with Methacholine challenge, X-ray, Pulse oximetry, Alpha-1 Antitrypsin blood test.

COPD vs. Pneumonia
COPD is a chronic disease. You have it all the time, even when you're not feeling sick. Pneumonia, on the other hand, is acute. You develop it over a short period of time and it makes you ill. You are then treated and hopefully recover completely, just as you would from a cold or the flu. Symptoms are very similar: Shortness of breath, cough, fever, and aches.

Pneumonia will make you feel ill and extremely fatigued, whereas COPD tends to make you short of breath in the long term and less able to perform some activities - but not feel sick, or acutely ill.
One important note is that people with COPD are more likely to develop pneumonia - but people who don't have COPD can definitely get pneumonia

Methods and Tests for Diagnosis for COPD and Pneumonia
Health history, listening to lung sounds, X-ray, blood tests to check for an increase in blood cells that fight infection, pulse oximetry, ABG (arterial blood gas).

We're out of time today, but watch for Part II: Is it COPD or Another Lung Condition? How Can You Tell? We will discuss Pulmonary Fibrosis, Lung Cancer, Black Lung Disease, and also find out what was wrong with my eye and how they figured it out.

Jane Martin
Meet Our Writer
Jane Martin

Jane Martin is an accomplished respiratory therapist, author and founder and director of Breathing Better, Living She wrote for HealthCentral as a health professional for COPD.