Diagnosing COPD

COPD is not always easy to identify. At first, COPD may show no symptoms. But as the disease progresses, symptoms appear and can become
more severe.

  • Shortness of breath (also called dyspnea) while doing everyday activities such as walking around the house, going up the stairs, or walking to the mailbox
  • An ongoing cough or a cough that produces a lot of mucus (also called phlegm or sputum). This is often called “smoker’s cough”
  • Wheezing
  • Chest tightness
  • Fatigue

Many symptoms do not appear until the disease has advanced; COPD can develop for years with no noticeable symptoms. Many people mistake their increased breathlessness and coughing for normal signs of aging.

COPD commonly affects people who are 40 years of age or older and who are current or former smokers. Even secondhand smoke is a risk.

Severe COPD
The severity of symptoms correlates with the extent of lung damage a patient has. If a patient continues to smoke, the damage will occur faster. Symptoms of severe COPD also include swelling in the ankles, feet, or legs; weight loss; and decreased lower-muscle endurance.1

Signs of severe COPD that require immediate medical attention include:

  • Difficulty catching a breath or talking
  • Lips or fingernails turning blue or gray
  • Lack of mental alertness
  • Fast heartbeat
  • Treatment prescribed for symptoms isn’t working

What is an exacerbation?
An exacerbation is a flare-up or worsening of COPD symptoms. It can occur from a lung infection, but in some instances, it is not known why some people have one. Symptoms of an exacerbation are similar to those found during an infection such as pneumonia. There is a change in the amount of sputum or color (from clear to deep yellow, green, or brown) and an increase in shortness of breath.

Tests for COPD
A diagnosis of COPD is made through a combination of tests. A healthcare provider will take a medical history and ask if the patient is a current or former smoker, or if they have had any contact with lung irritants, such as secondhand smoke, air pollution, chemical fumes, or dust. He or she will also ask if the patient has had an ongoing cough and if they bring up mucus when they cough. Using a stethoscope, a healthcare provider will listen for wheezing or any other abnormal chest sounds.

If a healthcare provider suspects COPD, he or she will usually perform a variety of lung function tests that measure how much air patients can inhale and exhale, how fast they can breathe out, and how well their lungs deliver oxygen to the bloodstream. The most common test is spirometry a painless test in which patients take a deep breath in and then blow as hard as they can into a tube that’s connected to a machine called a spirometer. This machine measures how much and how fast air is blown out.

Other lung function tests include:

  • Lung volume test measures how much air the lungs can hold
  • Lung diffusion capacity measures how well oxygen passes from the lungs into the bloodstream
  • Pulse oximetry measures blood oxygen levels
  • Arterial blood gas test: Oxygen and carbon dioxide levels are measured from a blood sample taken from an artery

Next page: Treating COPD