Diagnostic Approach Of COPD Essay

1.1.6 Diagnostic Approach Of COPD
A diagnosis of COPD warrants consideration in any patient who has symptoms of cough, sputum production, or Dyspnea or a history of exposure to risk factors. The diagnosis is usually confirmed by Spirometry [15]. Physical examination and chest imaging are insensitive methods for diagnosis of COPD. Physical findings of hyper inflated lungs, such as low-lying diaphragms, decreased breath sounds, and Hyperresonant chest percussion is highly specific for COPD, but usually only in advanced disease [29]. Early in the course of the disease, no specific abnormalities may be noted on physical examination. Wheezing may or may not be present and does not necessarily relate to the severity of airflow obstruction [30]. One study has suggested that a distance between the thyroid cartilage and the Sternal notch less than 4 cm in a smoker older than age 45 is highly …show more content…
Prolonged expiratory time is a more consistent finding in COPD, particularly as the disease progresses [30]. The recent Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines used the presence of a post bronchodilator FEV1 of less than 80% of the predicted value in combination with an FEV1/forced vital capacity (FVC) ratio of less than 70% to confirm the presence of airflow limitation that is not fully reversible, Lung volumes in emphysema demonstrate Hyperinflation, and diffusing capacity for carbon monoxide is low. In very severe disease, patients develop physical signs indicative of Hyperinflation, including a barrel-shaped chest, decreased breath sounds, distant heart sounds, and increased resonance to percussion [30]. Clubbing of the fingers is not common in COPD and, if present, suggests another diagnosis such as Bronchiectasis, Asbestosis, or lung cancer [29]. CT is not indicated in the routine diagnosis or evaluation of COPD, but can be helpful when

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