COPD, which causes airflow obstruction and difficulty breathing, is associated with several common symptoms, such as a cough, wheezing, and chest tightness. If the individual is still smoking or if they have chronic bronchitis as an important part of their COPD, they may have a chronic cough (also known as smoker’s cough) as well, adds Edelman.
WheezingChest tightnessConstant fatigue, which often results from the decreased muscle strength associated with a long-term inability to exerciseFrequent respiratory infections, including acute bronchitis (in emphysema patients) and pneumoniaCyanosis, a blueness of the lips and fingernail beds, which develops from tissues not getting an adequate amount of oxygenBarrel chest from the lungs being chronically overinflated with air (in emphysema)Reduced appetite and weight loss, resulting from the increased energy required to breatheInsomniaSwollen ankles, feet, or legs, which can signal more severe COPD
People with COPD often experience exacerbations, or periods of time when symptoms flare up. “An exacerbation is when a chronic disease gets worse for some reason. With COPD, this is usually because of infection,” says Richard Castriotta, MD, professor of clinical medicine at Keck School of Medicine of USC in Los Angeles. Exacerbations can also occur when environmental air pollution increases, he adds. In addition to assessing your symptoms, your physician will want to know about other factors in your history that may make COPD more likely. These factors include:
Smoking is by far the greatest risk factor for COPD. About 80 to 85 percent of people with COPD have smoked cigarettes for a significant amount of time, says Edelman. Smoking is the most common cause of COPD, accounting for as many as 8 out of 10 COPD-related deaths, according to the Centers for Disease Control and Prevention (CDC).Lung irritants such as air pollution, airborne toxins, or chemical fumes can increase the risk for COPD, says Edelman. Certain occupations that involve long-term exposure to inhaling dust may be a cause of COPD as well.Family history of COPD and alpha-1 antitrypsin (AAT) deficiency, a genetic disorder, can increase the risk of COPD and other diseases. If your body doesn’t make enough of the protein AAT, the lungs can be more easily damaged from smoking and environmental pollution, notes the NHLBI.Although there isn’t a cure, augmentation therapy may help slow lung damage. Augmentation therapy uses the plasma of healthy donors to increase alpha-1 levels in people with the deficiency, according to the Alpha-1 Foundation.Persistent asthma and allergies are an important risk factor for COPD, says Edelman. “Even people who haven’t smoked, if they’ve had asthma for a long time, it may change from asthma to COPD,” he says.
A physical exam is important to inspect the function of your lungs and heart, and look for other visible signs of COPD, such as cyanosis (blueness of the lips and fingernail beds). “We can frequently hear the air obstruction when we listen to the chest,” says Edelman. Your doctor may also ask you to blow into a device called a peak flow meter to assess your ability to exhale quickly and forcefully.
The Difference Between Asthma and COPD
COPD is almost always associated with smoking; asthma can occur in both smokers and nonsmokers. In asthma, when the airways tighten and you take medication, the airways go back to normal, says Edelman. “In COPD, even though medication may relieve the airway tightening, they never quite go back to normal; the airways have changed in structure enough that you can’t open them up fully,” he says.
Spirometry This involves blowing into a tube connected to a spirometer, a machine that measures the airflow into and out of the lungs. This is the standard respiratory function test used for the detection of COPD, and it is frequently the only test needed to diagnose the condition, per past research. “Technically, we can’t make a diagnosis of COPD unless there’s a certain degree of obstruction on a breathing test after the use of bronchodilators,” says Edelman.Bronchodilator Test This is a method for measuring the changes in lung capacity after inhaling a short-acting β-agonist that dilates the airway. When an obstructive defect is detected, this test helps to diagnose and evaluate asthma and COPD by measuring reversibility with the use of an inhaled bronchodilator, according to an article published in April 2017 in Tuberculosis and Respiratory Diseases.Lung Volume Test This procedure is similar to spirometry and is the most accurate way to measure how much air your longs can hold, per the NHBLI.Lung Diffusion Capacity This test is used to assess how well the lungs exchange gasses, which is important as a major function of the lungs is to allow oxygen to pass into the blood from the lungs and to allow carbon dioxide to diffuse from the blood into the lungs, according to MedlinePlus.Pulse Oximetry This test can measure the oxygen level or saturation of the blood. It’s performed with a device that clips on a body part such as your finger or your ear. It can be used to check the blood oxygen level of people with COPD, says Johns Hopkins Medicine.
Arterial Blood Gas Test This evaluates your lungs’ gas exchange capabilities by measuring the amounts of oxygen and carbon dioxide in your blood.AAT Deficiency The way to determine if someone has an AAT deficiency is through a blood test, per the NHLBI.Chest X-Rays X-rays are used to look for lung enlargement, bronchial scarring, and the formation of air-filled cavities in the lungs called bullae, according to RadiologyInfo.org.Computerized Tomography (CT) Scans This test provides pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. A CT scan can also indicate whether another condition, such as heart failure, is causing the symptoms, notes the NHLBI.Other Diagnostic Tests may also be necessary, such as a heart test called electrocardiogram (EKG), bronchoscopy (where a thin tube with a camera is inserted into the airways to examine the lungs), and a lung or bronchial biopsy, according to National Jewish Health.
Once you have a proper diagnosis, you can begin treatment to slow the progression of COPD and relieve symptoms.
