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Diagnosing COPD

Reviewed by: HU Medical Review Board | Last reviewed: July 2021.

A chronic obstructive pulmonary disease (COPD) diagnosis is the first step in managing the disease and preventing further lung damage. A COPD diagnosis is typically based on 3 things:1,2

  • Showing symptoms of COPD
  • Exposure to certain risk factors that make COPD more likely
  • Breathing test results

Your doctor should start the diagnosis process by asking about your symptoms, lifestyle, and medical and family history. This will help to determine any risk factors. Risk factors are certain things that might make someone more likely to have COPD. From here, your doctor may determine it is best to move on and order tests.1,2

COPD is commonly misdiagnosed. Many people also do not realize they have COPD until the disease has become more serious. Getting an accurate COPD diagnosis as quickly as possible is an important step in managing the disease. Because lung damage cannot be reversed, an early diagnosis can help buy time in the fight against COPD.1,2

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What symptoms can be signs of COPD?

It is sometimes hard for people to recognize the symptoms of COPD until the disease has progressed. If you are at risk and experience these symptoms, you should talk with your doctor:1-3

  • A cough that does not go away
  • Shortness of breath
  • Wheezing
  • Tiredness
  • Light blue lips or fingernail beds
  • Regular respiratory infections
  • Increased mucus production
  • Unexplained weight loss

These symptoms may get worse while exercising or during other physical activities.1

What are risk factors for COPD?

Risk factors for COPD are things in a person’s work, family, or medical history that can cause a higher risk of getting COPD. COPD symptoms, like shortness of breath, can be caused by many different diseases. Because of this, doctors will ask about risk factors to determine if COPD is more likely for a certain person. If a person has 1 or more risk factors for COPD, it is more likely that their symptoms are caused by COPD and not something else.3

The strongest risk factor for COPD is being a current or former smoker. Another risk factor is working in a place where you breathe in irritants on a regular basis.1

A very small percentage of people have a higher risk for COPD because of a genetic condition called Alpha-1 antitrypsin deficiency. If you have a lot of relatives who have COPD, this may be a sign you are more likely to have it.1

If COPD seems likely based on your symptoms and risk factors, then special testing can help your doctor make a diagnosis.

What kinds of tests are used to diagnose COPD?

The last step in a COPD diagnosis is breathing tests to measure how well your lungs are working. The most common test used to diagnose COPD is called a spirometry test. A spirometry test is simple and noninvasive.3

During the spirometry test, you will be asked to blow all the air in your lungs into a mouthpiece on a machine. The machine measures how much air you can blow out and how quickly you can blow it. The results of a spirometry test can also show your doctor what stage your COPD is. There are 4 COPD stages, and doctors use them along with spirometry test results to help decide on treatment.3

Your doctor may also use imaging tests. Your doctor can use these images to understand any lung damage you have. They can also help determine if your symptoms are being caused by something besides COPD. These tests might include:1,2

Other tests can be used to determine how much oxygen is in your blood. Low oxygen is a sign your lungs are not working as well as they should. This type of test is called an arterial blood gas test.3