Chronic Obstructive Pulmonary Disease Initial Assessment

Clinical Presentation 

A diagnosis of COPD should be considered in patients over 40 years of age who have a suggestive medical history (ie presence of risk factors) and who present with any of the following: 

• Chronic cough (present intermittently or daily): Cough may be unproductive and does not reflect the major impact of airflow limitation on morbidity and mortality in patients with COPD
• Exertional breathlessness, wheezing, pursed-lip breathing, dyspnea with or without wheezing 
• Rhonchi, prolonged expiratory phase of respiration, chest hyperinflation, use of accessory muscles for respiration, decreased breath sounds 
• Signs of cor pulmonale: Neck vein distention, increased pulmonic component of second heart sound, lower extremity edema, hepatomegaly
• The absence of wheezing or chest tightness does not rule out a diagnosis of COPD