Identifying COPD

Chronic obstructive pulmonary disease commonly called as COPD is a dreadful disease of the respiratory system. It is a combination of four lung diseases which includes chronic bronchitis, emphysema, bronchiectasis and asthma. It is not a communicable disease but it is an irreversible disease. It is said to be the fourth most common cause of deaths in United States and it affects over 25% of adult population.

SIGNS AND SYMPTOMS OF COPD: The clinical manifestation ranges from pink puffers to blue bloaters. The pink puffer is due to emphysema and the blue bloater is due to chronic bronchitis. The pink puffer state is due to redder complexion and the blue bloater state is due to cyanosis of the lips, nail and skin caused by increased carbon dioxide and decreased oxygenation to the lungs.

SIGN: The signs of COPD include,
1. On inspection, a typical COPD patient will
a. have a barrel chest (due to emphysema),
b. use their accessory muscles for breathing (sternocleidomastoid),
c. cyanosis,
d. Clubbing of fingers,
e. dyspnea,
f. shortness of breath,
g. tachypnea,
h. pursed lip breathing,
i. muscle wasting,
j. distended neck veins.
2. On percussion, the lung will sound dull or hyper-resonance instead of being resonant due to excessive mucus production and collection in the lungs.
3. On palpation, there can be,
a. palpable cervical lymph nodes (chronic bronchitis)
b. deviation of trachea (rarely)
c. asymmetrical chest wall movements (due to obstruction)
d. decreases tactile fremitus (emphysema)
4. On auscultation, you can identify a number of things like,
a. Wheezing and crackles (asthma)
b. cardiac dysrhythmias
c. tachycardia (due to increased effort to breath)
d. rales and rhonchi (due to congestion)
e. diminished breath sounds
f. prolonged expiration

X-rays show hyperinflation and congestion.

Arterial blood gas (ABG) will indicate respiratory acidosis and hypoxemia.

Pulmonary function test (PFT) will indicate decreased vital capacity, increased residual volume and slightly increased total lung capacity.

SYMPTOMS: A symptom is what the patient experiences and complaints due to a particular disease. The common symptoms are,
a. chronic cough
b. presence of sputum in cough
c. exertional dypnea
d. orthopnea
e. wheezing
f. tachypnea
g. shortness of breath
h. weight loss
i. fatigue
j. anorexia

Above are the classical signs and symptoms of COPD which are exhibited slowly as age increases. Avoid smoking, air pollution and occupational exposure to radiations/chemicals and avoid COPD!