Fast Five Quiz: COPD Presentation and Diagnosis

Zab Mosenifar, MD


April 27, 2021

Physical examination can be quite specific and sensitive for advanced COPD. For instance, an elevated jugular venous pulse is observed in patients with severe disease. Other signs and symptoms may include cyanosis, tachypnea and respiratory distress with simple activities, use of accessory respiratory muscles and paradoxical indrawing of lower intercostal spaces (Hoover sign), and peripheral edema.

The American Thoracic Society and Global Initiative for Chronic Obstructive Lung Disease have developed staging criteria for assessing the severity of airflow obstruction (based on the percent predicted postbronchodilator FEV1 when the FEV1/FVC is < 70%). They are as follows:

  • Stage I (mild): FEV1 ≥ 80% of predicted

  • Stage II (moderate): FEV1 50%-79% of predicted

  • Stage III (severe): FEV1 30%-49% of predicted

  • Stage IV (very severe): FEV1 < 30% of predicted or FEV1

The respiratory rate increases in proportion to disease severity.

Learn more about the presentation of COPD.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.