Certain characteristics allow differentiation between patients with COPD who present predominantly with chronic bronchitis and those who present predominantly with emphysema.
Chronic bronchitis characteristics include the following:
Patients may be obese.
Frequent cough and expectoration are typical.
Use of accessory muscles of respiration is common.
Coarse rhonchi and wheezing may be heard on auscultation.
Patients may have signs of right heart failure (ie, cor pulmonale), such as edema and cyanosis.
Emphysema characteristics include the following:
Patients may be very thin, with a barrel chest.
Patients typically have little or no cough or expectoration.
Breathing may be assisted by pursed lips and use of accessory respiratory muscles; patients may adopt the tripod sitting position.
The chest may be hyperresonant, and wheezing may be heard.
Heart sounds are very distant.
Overall appearance is more like that of a classic COPD exacerbation.
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Cite this: Zab Mosenifar. Fast Five Quiz: COPD Key Aspects - Medscape - Aug 10, 2020.