Learn about Chronic obstructive pulmonary disease diagnosis at Consumer Reports Health.

Chronic obstructive pulmonary disease

How do doctors diagnose COPD?

To find out if you have chronic obstructive pulmonary disease (COPD), your doctor will look at these things:

If you smoke
If you work with harmful gases or chemicals
Your symptoms
Your health now (you'll have a physical examination)
Your health in the past and any health problems in your family (this is your medical history)
Results from tests that measure how well your lungs work.

To find out if you are at high risk of having COPD, your doctor will ask whether you smoke now or whether you did in the past. Nearly everyone who has COPD is a smoker or used to smoke. But some people have inhaled only secondhand smoke.

Information about where you work and what you do will help your doctor know how likely it is that you have this disease. Your doctor will also ask about your symptoms and about any other illnesses you've had.

He or she will examine you and listen to your chest to see how well you are breathing and if you have any signs of a chest infection.

Here are some questions your doctor may ask.

Do you cough every day? How often?
How long have you been coughing like this?
Do you cough up mucus (also called phlegm)? What does it look like?
Do you feel out of breath a lot? What makes you feel breathless?
Do you get a lot of chest

infection
You get an infection when viruses, bacteria, fungi or other tiny organisms get into your body. These bugs are so tiny that you can't see them without a microscope. For example, an infection in your airways causes the common cold. And an infection in your skin can cause rashes such as athlete's foot.

infections?
Are you losing weight?
Does anyone in your family have

chronic bronchitis
Your doctor may say that you have chronic bronchitis if you have a cough that brings up phlegm, if it lasts for three months or more, and you have had it twice in two years. Smoking is a common cause of chronic bronchitis.

chronic bronchitis?

emphysema
Emphysema is a long-term disease of the lungs. The walls of the air sacs (alveoli) in the lungs become thin and less elastic. This makes it harder for oxygen to get in your blood and carbon dioxide to get out of your body. It makes you cough and feel short of breath. Smoking is the most common cause of emphysema.

Emphysema? COPD? Any other breathing problem?
Have you had, or do you have, heart trouble or lung problems of any kind? Do you have any other illnesses?
Are your symptoms affecting your work, sleep, leisure or other everyday activities?

To see how healthy your lungs are, your doctor may need to do some of the tests listed below.

Spirometry: This helps to find out how well your lungs work by measuring how much air you can breathe in and out (see Spirometry to find out more). You may have this test in your doctor's office or you may need to see a specialist.
Walking test: This will measure how fast you get out of breath.
Chest X-ray: An

X-ray
X-rays are pictures taken of the inside of your body. They are done by passing very small amounts of radiation through your body and onto film. X-rays can also be used as a treatment, such as in radiation therapy for cancer.

X-ray will usually show whether you have (or don't have) any other lung diseases.
Electrocardiogram (ECG or EKG) or echocardiogram ("echo"): These tests will tell the doctor if your heart is not beating or pumping properly and if this is making you breathless.
CT scan: Your doctor may want to do a

CT scan
A CT scan is a type of X-ray. It takes several detailed pictures of the inside of your body from different angles. CT stands for computed tomography. It's also called a CAT scan (computed axial tomography).

CT scan to get a more detailed picture of your lungs.
A blood test to measure blood gases: This shows how much oxygen and carbon dioxide you have in your blood. See Blood gases to find out more.

Grading COPD

You can have COPD that's pretty mild, a little worse or very bad. If it looks as if you might have COPD, your doctor will give your illness a grade to show how mild or severe it is. The grade helps your doctor decide what treatment you need.

Source:
Global initiative for chronic obstructive lung disease.
Global initiative for chronic obstructive lung disease.
Available at http://www.goldcopd.com (accessed on 28 November 2008).

There are four grades, and the table below shows what they are and what each one means. If your doctor gives your illness a 0, it means you might get COPD, but you don't actually have the disease yet. The highest grade, 4, means you have COPD and it's very serious.

You'll see one abbreviation in the table below: FEV 1. This measurement is used in spirometry tests. It stands for forced expiratory volume in one second. It shows how much air you can blow out in the first second of the test.

To grade your COPD, doctors look at your FEV1 score. This gives them a percentage that helps them find out how well your lungs are working. To learn more, see Spirometry.

Stage of COPD	Test results	Signs
0: At risk	Your lung test is normal.	You have had symptoms, like coughing up mucus, every day for some time.
1: Mild	Your FEV1 is at least 80 percent of what it should be.	You may cough a lot. Sometimes you cough up mucus. You may feel a little breathless if you walk quickly, but you may not think there's anything wrong
2: Moderate	Your FEV1 is between 50 percent and 80 percent of what it should be.	You cough more. You may get breathless if you work hard, walk quickly or do household jobs. You may take a few weeks to recover from a chest infection.
3: Severe	Your FEV1 is between 30 percent and 50 percent of what it should be.	You may not be able to work and probably find it harder do jobs around the house. You cannot walk upstairs or across the room very well. You get tired easily. You may show signs of a weak heart.
4: Very severe	Your FEV1 is less than 30 percent of what it should be or it's less than 50 percent of what it should be and you have other signs that your lungs are failing.	You can no longer go to work or do jobs around the house. You cannot walk upstairs or across the room very well. You may show signs of a weak heart.

Sources for the information on this page:

Global initiative for chronic obstructive lung disease.Global initiative for chronic obstructive lung disease.Available at http://www.goldcopd.com (accessed on 28 November 2008).

This information was last updated on Jul 14, 2009

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