Chronic obstructive pulmonary disease history and symptoms
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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 a group of diseases that can present with symptoms such as shortness of breath, wheezing, persistent cough and sputum production. Some clinical differences can help distinguish between the types of COPD. While chronic bronchitis patient present with productive cough with gradual progression to intermittent shortness of breath; recurrent pulmonary infections; and in later stage progressive cardiac/respiratory failure presenting with edema and weight gain. Classic findings for patients with emphysema include a long history of progressive shortness of breath with late onset of nonproductive cough; usually mucopurulent; and eventual decrease in appetite and respiratory failure.
History
The patient may present with a chronic history (lasting for years) of progressive shortness of breath (emphysema) or productive cough (chronic bronchitis). History may involve patient doing life style modifications to deal with the shortness of breath. History of being chronic smoker (usually more than 40 pack year) is also commonly found.
Symptoms
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). In clinical practice, COPD is defined by its characteristically low airflow on lung function tests.[1] In contrast to asthma, this limitation is poorly reversible and usually gets progressively worse over time.
Chronic bronchitis
- Productive cough with gradual progression to intermittent shortness of breath. [2] It is possible the sputum may contain blood (hemoptysis), usually due to damage of the blood vessels of the airways. An acute exacerbation may present as productive cough or an acute chest illness is common. The cough usually is worse in the mornings and produces a small amount of colorless sputum. The frequency and severity of acute exacerbation usually increases as the disease progresses.
- Recurrent pulmonary infections
- In later stages progressive cardiac/respiratory failure may present with edema and weight gain.
Emphysema
- A long history of progressive shortness of breath with late onset of nonproductive cough; usually mucopurulent; and eventual decrease in appetite and respiratory failure.
Severe COPD
- Cyanosis (bluish decolorization usually in the lips and fingers) caused by a lack of oxygen in the blood
- Patient may have confusion indicating an alteration of mental status
- In extreme cases it could lead to cor pulmonale due the extra work required by the heart to get blood to flow through the lungs.
- Decreased fat-free mass, impaired systemic muscle function (systemic manifestation)
- Depression
The most helpful information in diagnosis of COPD is provided by a combination of the following 3 signs [3]
- Self-reported smoking history of more than 55 pack-year
- Wheezing on auscultation
- Self-reported wheezing.
References
- ↑ Template:Cite doi [1]
- ↑ U.S. National Heart Lung and Blood Institute - Signs and Symptoms
- ↑ Qaseem A, Wilt TJ, Weinberger SE, Hanania NA, Criner G, van der Molen T, Marciniuk DD, Denberg T, Schünemann H, Wedzicha W, MacDonald R, Shekelle P (2011). "Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society". Annals of Internal Medicine. 155 (3): 179–91. doi:10.1059/0003-4819-155-3-201108020-00008. PMID 21810710. Unknown parameter
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