How Is COPD Diagnosed?

There is no one test for diagnosing COPD. It usually involves a series of questions, assessments, and tests.

A diagnosis may result from a doctor learning…

Your age.

COPD is rarely diagnosed when you are under the age of 40. This is because it is usually the end result of years of exposure to something in your environment. Exposure to cigarette smoke is one example.

What you look like.

So, you present to your doctor with shortness of breath. You have a cough that doesn’t seem to go away. You produce sputum that is a yellowish in color. The skin around your lips and fingertips has a bluish tinge. You have a barrel chest. You have hunched shoulders. You appear to be working to breathe.

Your reported history.

You report to have smoked cigarettes for many years. You report working at a job that exposed you to dust or chemicals. This would include years of cooking over a wood stove. It would include jobs where you inhaled fumes or vapors. You report feeling short of breath, either sometimes or all the time. You report that this shortness of breath has gotten worse over time. You report feeling short of breath with exertion. You report coughing, either sometimes or every day. You report coughing up lots of sputum, or sputum that is yellow. You have a history of lung infections, like pneumonia.

What you sound like.

A doctor may use a stethoscope to listen to your lung sounds. He may hear a wheeze. He may hear less air movement than normal. He may hear other abnormal sounds typical of people with COPD. A doctor will listen to how you talk. Do you talk in short-choppy sentences? This may be typical of a COPD flare-ups. Do you have a cough? Again, this can be a sign of COPD.

Your family history.

Your parents or siblings or other immediate family members have asthma or COPD.

Your test results.

The main test used for diagnosing COPD is a pulmonary function test (PFT). It’s sometimes referred to as spirometry. It involves inhaling and exhaling into a machine. The results can’t diagnose COPD, but they can point the finger in that direction. They can show if you have obstructed airways.

Still, there are times doctors may make a diagnosis of COPD even when this testing is not performed. For instance, you present to the emergency room with shortness of breath. You report that you smoke cigarettes. Or, you report working certain high-risk jobs

There are also other tests that may show COPD. For instance, a pulse oximeter or arterial blood gas (ABG) may show low oxygen levels. An ABG is another test that can point the finger at COPD. This is a test that I (your respiratory therapist) will do.

Oh, and there’s one other test that can confirm COPD. There is a rare form of COPD called alpha-1 antitrypsin deficiency. It’s diagnosed by genetic testing or a blood test.

A doctor may perform a differential diagnosis to determine if there is another disease that may be causing your symptoms. These include asthma, cystic fibrosis, heart failure, lung cancer, or pneumonia. While they have similar symptoms, they have different treatment strategies. So, sometimes, getting to a diagnosis of COPD involves ruling out these diseases first.

What to make of this?

If you have COPD, you will want a proper diagnosis. Sometimes diagnosing you is easy. Other times it involves lots of doctors’ appointments and tests. Getting a proper diagnosis is important. It can help you live longer and better with COPD.

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