As in all medical conditions, the diagnosis of COPD is the combination of subjective clinical impression with objective observations. Spirometry is the primary objective test, and is fundamental to making a confident diagnosis of COPD.
Consider a diagnosis of COPD in patients who are:
- over 35
- smokers or ex-smokers
- have any symptoms of exertional breathlessness, chronic cough, regular sputum, production, frequent winter ‘bronchitis’, wheeze
- and have no clinical features of asthma
Patients typically present with a combination of signs and symptoms of cough, worsening breathlessness, progressive exercise intolerance, productive cough, wheeze and repeated chest infections. Smokers are more susceptible to prolonged complicated infections due to histopathological and immunological changes in their respiratory tract, and therefore there is increasing evidence implicating viral infections of the respiratory tract to underlying COPD.