COPD  is a chronic (long-term) lung disease, usually caused by smoking. Emphysema and Chronic Bronchitis are the main forms of chronic obstructive pulmonary disease (COPD). Diagnosing COPD usually requires pulmonary function tests, combined with a history of symptoms, such as shortness of breath. There is no emphysema cure other than lung transplantation. However, COPD treatments can improve symptoms and preserve lung function.

Making the COPD Diagnosis

Diagnosing COPD often includes the following evaluation:

History: A person with COPD usually describes slowly worsening shortness of breath, over a period of months or years and cough which could be dry or with expectoration. He or she also likely smoked for many years. Symptoms may also include wheezing.

Physical exam: In mild copd, a doctor’s examination may reveal no evidence of COPD. In people with more advanced COPD, a doctor may notice these findings:

• Increased chest size or “barrel chest” (from abnormally expanded lungs in emphysema)
• Decreased breath sounds through the stethoscope
• Rounded fingertips (clubbing)
• Pursed-lip breathing
• Hypoxemia (hypoxia): Low oxygen levels in the blood, detected on pulse oximetry or arterial blood gas testing
• Hypercarbia: High levels of carbon dioxide in the blood. This results from an inability to exhale properly in COPD
• Cyanosis: Blue-tinged lips, resulting from low oxygen in severe COPD
• Malnutrition: Muscles slowly waste away in advanced emphysema

Pulmonary function tests (PFTs): A person sits inside an enclosed booth and breathes into a tube. As someone performs various breathing maneuvers, PFTs measure:

• How much air the lungs can hold
• How rapidly a person can blow out air from their lungs
• How much air remains trapped in the lungs after exhalation
• Whether any airflow limitations improve with inhaled bronchodilator medicines, such as salbutamol
• People with normal lungs can blow out most of the air in their lungs in one second. With COPD, it’s more likely to take longer to empty the lungs.

Chest X-ray film: A chest X-ray of someone with COPD maybe normal or  may show abnormally large lungs. Diagnosing COPD can’t be done with an X-ray alone.

Computed tomography (CT scan) of the chest: A CT scan in someone with COPD may show small pockets of air throughout the lung. These areas of damaged lung are where air becomes trapped, making forceful exhalation difficult.

Complete blood count: This simple blood test usually shows normal amounts of white and red blood cells. In advanced COPD, the red blood cell count may rise. Infections may cause an elevated white blood cell count.