29th April 2024

A 68-year-old man, a former smoker, presents with a persistent cough, increasing shortness of breath, and wheezing for the past two years.

A 68-year-old man, a former smoker, presents with a persistent cough, increasing shortness of breath, and wheezing for the past two years. He reports a history of heavy smoking but quit 10 years ago. His symptoms have progressively worsened, and he now struggles with daily activities such as climbing stairs. On examination, he exhibits a prolonged expiratory phase with diffuse wheezing and decreased breath sounds in both lungs. His chest X-ray shows hyperinflation and flattened diaphragms. Pulmonary function tests indicate obstructive pattern without significant reversibility after bronchodilator administration.

Which is the most likely diagnosis?