To make an accurate diagnosis of COPD requires consideration of a variety of areas:

An accurate diagnosis must be made using

1. History



Family History

Positive FH of asthma-resources/atopy


Personal History

Previous asthma or history suggestive of childhood asthma

Atopic illness

Fit childhood – but possible history of severe lower respiratory infection

Social History

+/- current or ex-smoker

Current or ex-smoker with 20+ pack years

Possible significant occupational exposure


Symptoms often at an arly age

Over 35


  Slowly progressive shortness of breath on exertion
Wheeze/cough – often nocturnal

Cough +/- sputum – particularly in the morning no nocturnal disturbance

‘Good days and bad days’

No variation from day-to-day 

2. The Basic Examination

It is helpful to look at the shape of the patient’s chest and their pattern of breathing.

  1. Patients are abnormally breathless
  2. Overinflation of the lungs – barrel shaped appearance
    Possibly leading to displacement of abdominal organs, may make the patient appear ‘pot bellied’
  3. Ask the patient to cough and listen carefully (productive sound of excess airway secretions and the wheeze of airflow obstruction)

Mild COPD is largely asymptomatic and physical examination is likely to be normal. These patients may only be detected using a spirometer.

3. Pulmonary Function Test

Simple pulmonary function tests are done for two main reasons in COPD.

  1. To make the diagnosis of airway obstruction
  2. To assess the progression of the disease

(See spirometry section).

Further Investigations


Useful Links

Diagnosing Severity of COPD...

Management of Stable COPD...

Performing Spirometry...

The Treatment of Exacerbations in COPD...

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