What is COPD?
COPD is characterised by airflow obstruction. The airflow obstruction is usually progressive, not fully reversible, and does not change markedly over several months. It is predominantly caused by smoking (National Collaborating Centre for Chronic Conditions [NCCCC] 2004). Since airflow obstruction is predominantly fixed, most patients have symptoms that vary little from day-to-day or from week-to-week.
The Spectrum of COPD
A diagnosis of COPD should be considered in patients who are:
- Over 35
- Smokers or ex-smokers
- Have any of the following symptoms
- Exertional breathlessness
- chronic cough
- regular sputum production
- frequent winter bronchitis
- wheeze
- And have no clinical features of asthma
(NICE, 2010)
Signs and Symptoms
| Main Symptoms in COPD |
- Breathlessness on exertion
- Cough
- Sputum Production
- Wheeze
- Chest tightness
- Anxiety
- Panic
|
- Depression
- General malaise
- Forgetfulness
- Lack of concentration
- Loss of appetite & weight
- Impaired sleep
|
| Main Signs of COPD |
- Overinflation of the thorax
- Increased inspiratory effort
- Pursed lip breathing
- Central cyanosis
- Peripheral oedema
- Raised jugular venous pressure
|
Risk Factors and Prevention
Inherited Susceptibility:
Serum alpha1-antitrypsin
Alpha1-antitrypsin deficiency is a rare, genetic cause of COPD and should be considered in the following cases:
- COPD in a non-smokers
- Early onset of COPD
- Family history of alpha1-antitrypsin deficiency, or of early-onset COPD
(NICE, 2010; National Collaborating Centre for Chronic Conditions, 2004)
Useful Links
More information about COPD & Smoking...
Management of chronic obstructive pulmonary disease in adults in primary and secondary care guideline (partial update)...
Clinical features differentiating COPD and asthma - 