How is chronic obstructive pulmonary disease (COPD) diagnosed?

Medical history

To diagnose COPD, the physician needs the answers to the following questions:

  • Do you smoke?
  • Have you had chronic exposure to dust or air pollutants?
  • Do other members of your family have lung disease?
  • Are you short of breath?
  • Do you get short of breath with exercise?
  • Do you have chronic cough and/or wheezing?
  • Do you cough up excess mucus?

Physical exam

To help with the diagnosis, the physician will conduct a thorough physical exam, which includes:

  • Listening to your lungs and heart
  • Checking your blood pressure and pulse
  • Examining your nose and throat
  • Checking your feet and ankles for swelling

Laboratory and other tests

Several laboratory and other tests are needed to confirm a diagnosis of COPD. These tests might include:

  • Electrocardiogram (ECG or EKG) to check heart function and rule out heart disease as a cause of shortness of breath
  • Chest X-ray to look for lung changes that could be caused by COPD
  • Spirometry and pulmonary function tests (PFTs) to determine lung volume and air flow
  • Pulse oximetry to measure the saturation of oxygen in the blood
  • Arterial blood gases (ABGs) to determine the amount of oxygen and carbon dioxide in the blood
  • Exercise testing to determine if the oxygen level in the blood drops during exercise

You might also talk to your doctor about whether testing for alpha-1 antitrypsin deficiency is appropriate for you.

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