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Clinical features, spirometry, and lung function 

Clinical features, spirometry, and lung function
Chapter:
Clinical features, spirometry, and lung function
Author(s):

Farid Bazari

, Trevor T. Hansel

, Michael I. Polkey

, and Onn Min Kon

DOI:
10.1093/med/9780199549146.003.0003
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date: 23 February 2020

Major indicators for considering a diagnosis of COPD are a history of (1) progressive dyspnoea on exertion, (2) a chronic productive cough, and (3) a history of exposure to risk factors.

It is important to consider systemic features of COPD: including weight loss, muscle weakness, cor pulmonale, sleep abnormalities, and decreased exercise performance.

Co-morbidities are common in COPD patients: ischaemic heart disease, carcinoma of the bronchus, depression, metabolic syndrome, endocrine abnormalities (diabetes mellitus, thyroid disorders, hypogonadism), anaemia, and osteoporosis.

COPD is characterized by airflow obstruction with a forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ratio of <0.7.

The FEV1 is a predictor of mortality in COPD and useful for monitoring disease progression and response to therapy.

Hyperinflation and air-trapping are indicated by a rise in the residual volume.

The gas transfer is reduced in emphysema because of destruction of the alveolar-capillary membrane.

Dynamic tests such as the 6-min walk distance can be used to assess response to therapy.

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