Chronic obstructive pulmonary disease differential diagnosis: Difference between revisions
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[[Chronic obstructive pulmonary disease]] is characterized by the pathological limitation of airflow in the airway that is not fully reversible <ref name="pmid12198919">{{cite journal |author=Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC |title=Chronic obstructive pulmonary disease surveillance--United States, 1971-2000 |journal=[[MMWR. Surveillance Summaries : Morbidity and Mortality Weekly Report. Surveillance Summaries / CDC]] |volume=51 |issue=6 |pages=1–16 |year=2002 |month=August |pmid=12198919 |doi= |url= |accessdate=2012-03-01}}</ref>. COPD is the umbrella term for chronic bronchitis, emphysema and a range of other lung disorders. This leads to a limitation of the flow of air to and from the lungs, causing [[shortness of breath]] (dyspnea), cough, and wheezing. In clinical practice, COPD is defined by its characteristically low airflow on [[lung function test]]s.<ref name=Nathell>{{cite doi|10.1186/1465-9921-8-89}} [http://respiratory-research.com/content/8/1/89]</ref> In contrast to [[asthma]], this limitation is poorly reversible and usually gets progressively worse over time. It should be differentiated from certain conditions that have similar presentation for instance [[congestive heart failure]], [[chronic asthma]], [[bronchiectasis]], and [[bronchiolitis obliterans]]. | [[Chronic obstructive pulmonary disease]] is characterized by the pathological limitation of airflow in the airway that is not fully reversible <ref name="pmid12198919">{{cite journal |author=Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC |title=Chronic obstructive pulmonary disease surveillance--United States, 1971-2000 |journal=[[MMWR. Surveillance Summaries : Morbidity and Mortality Weekly Report. Surveillance Summaries / CDC]] |volume=51 |issue=6 |pages=1–16 |year=2002 |month=August |pmid=12198919 |doi= |url= |accessdate=2012-03-01}}</ref>. COPD is the umbrella term for chronic bronchitis, emphysema and a range of other lung disorders. This leads to a limitation of the flow of air to and from the lungs, causing [[shortness of breath]] (dyspnea), cough, and wheezing. In clinical practice, COPD is defined by its characteristically low airflow on [[lung function test]]s.<ref name=Nathell>{{cite doi|10.1186/1465-9921-8-89}} [http://respiratory-research.com/content/8/1/89]</ref> In contrast to [[asthma]], this limitation is poorly reversible and usually gets progressively worse over time. It should be differentiated from certain conditions that have similar presentation for instance [[congestive heart failure]], [[chronic asthma]], [[bronchiectasis]], and [[bronchiolitis obliterans]]. | ||
==Differentiating Chronic | ==Differentiating Chronic Obstructive Pulmonary Disease from other Diseases== | ||
===Features Specific for Congestive | ===Features Specific for Congestive Heart Failure=== | ||
[[Chronic obstructive pulmonary disease]] (COPD) may be confused with congestive heart failure due to similar presentations like [[wheezing]] and shortness of breath. Features specific to congestive heart failure are: | [[Chronic obstructive pulmonary disease]] (COPD) may be confused with congestive heart failure due to similar presentations like [[wheezing]] and shortness of breath. Features specific to congestive heart failure are: | ||
* [[Orthopnea]] | * [[Orthopnea]] | ||
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* Clubbing | * Clubbing | ||
* CT findings suggestive of Bronchiectasis. | * CT findings suggestive of Bronchiectasis. | ||
===Features Specific for Bronchiolitis | ===Features Specific for Bronchiolitis Obliterans=== | ||
* History of collagen vascular disease. | * History of collagen vascular disease. | ||
* Young patient usually without a history of smoking | * Young patient usually without a history of smoking | ||
* CT scan shows finding of mosaic attenuation and no evidence of emphysema. | * CT scan shows finding of mosaic attenuation and no evidence of emphysema. | ||
===Features Specific for | ===Features Specific for Chronic Asthma=== | ||
* Chronic asthma responds well to bronchodilators. | * Chronic asthma responds well to bronchodilators. | ||
* Normal diffusion capacity of lung on pulmonary function test. | * Normal diffusion capacity of lung on pulmonary function test. | ||
Revision as of 15:37, 22 April 2013
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Differentiating Chronic obstructive pulmonary disease from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Philip Marcus, M.D., M.P.H. [3]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [4]
Overview
Chronic obstructive pulmonary disease is characterized by the pathological limitation of airflow in the airway that is not fully reversible [1]. COPD is the umbrella term for chronic bronchitis, emphysema and a range of other lung disorders. This leads to a limitation of the flow of air to and from the lungs, causing shortness of breath (dyspnea), cough, and wheezing. In clinical practice, COPD is defined by its characteristically low airflow on lung function tests.[2] In contrast to asthma, this limitation is poorly reversible and usually gets progressively worse over time. It should be differentiated from certain conditions that have similar presentation for instance congestive heart failure, chronic asthma, bronchiectasis, and bronchiolitis obliterans.
Differentiating Chronic Obstructive Pulmonary Disease from other Diseases
Features Specific for Congestive Heart Failure
Chronic obstructive pulmonary disease (COPD) may be confused with congestive heart failure due to similar presentations like wheezing and shortness of breath. Features specific to congestive heart failure are:
- Orthopnea
- Paroxysmal nocturnal dyspnea
- Fine crackles on ausculatation
- Chest X ray findings of cardiac enlargement, pulmonary congestion (Kerley B lines, and pleural effusion)
- The peak expiratory flow is low in COPD whereas there is higher flow in heart failure
- Comet-tail sign on ultrasonography is a good indicator of heart failure–related dyspnea [3]
Features Specific for Bronchiectasis
- Copious purulent sputum
- Coarse crackles
- Clubbing
- CT findings suggestive of Bronchiectasis.
Features Specific for Bronchiolitis Obliterans
- History of collagen vascular disease.
- Young patient usually without a history of smoking
- CT scan shows finding of mosaic attenuation and no evidence of emphysema.
Features Specific for Chronic Asthma
- Chronic asthma responds well to bronchodilators.
- Normal diffusion capacity of lung on pulmonary function test.
References
- ↑ Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC (2002). "Chronic obstructive pulmonary disease surveillance--United States, 1971-2000". MMWR. Surveillance Summaries : Morbidity and Mortality Weekly Report. Surveillance Summaries / CDC. 51 (6): 1–16. PMID 12198919. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Template:Cite doi [1]
- ↑ Prosen G, Klemen P, Strnad M, Grmec S (2011). "Correction: Combination of lung ultrasound (a comet-tail sign) and N-terminal pro-brain natriuretic peptide in differentiating acute heart failure from chronic obstructive pulmonary disease and asthma as cause of acute dyspnea in prehospital emergency setting". Critical Care (London, England). 15 (6): 450. doi:10.1186/cc10511. PMID 22188907. Retrieved 2012-03-05. Unknown parameter
|month=ignored (help)