The value of patient history and physical examination was addressed in the 2013 update to the American College of Physicians/American College of Chest Physicians/American Thoracic Society/European Respiratory Society (ACP/ACCP/ATS/ERS) guideline for diagnosis and management of stable COPD. According to the current guideline, a history of more than 40 pack-years of smoking was the best single predictor of airflow obstruction; however, the most helpful information was provided by a combination of the following three signs:
Self-reported smoking history of more than 55 pack-years;
Wheezing on auscultation; and
Self-reported wheezing.
If all three signs are absent, airflow obstruction can be nearly ruled out. COPD is now known to be a disease with systemic manifestations, and the quantification of these manifestations has proved to be a better predictor of mortality than lung function alone. Many patients with COPD may have decreased fat-free mass, impaired systemic muscle function, osteoporosis, anemia, pulmonary hypertension, cor pulmonale, and even left-sided heart failure. Depression is not uncommon in persons with COPD.
For more information on the presentation of COPD, read here.
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Cite this: Fast Five Quiz: Can You Properly Identify and Treat COPD? - Medscape - Sep 30, 2014.
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