5th January 2024

Presentation 

Patients commonly present with a combination of signs and symptoms of emphysema and chronic bronchitis. 

Symptoms of COPD include the following:

• Cough, which is usually productive of a small amount of colourless sputum and worse in the mornings.
• Breathlessness is one of the primary symptoms of COPD and usually exertional.
• Self-reported wheeze, generally during exercise or exacerbations.

Physical examination findings have a poor sensitivity in detecting mild to moderate disease; however, physical signs are quite specific and sensitive for severe disease. Signs in severe disease include the following:

• Tachypnoea with simple activities
• Accessory muscle use
• Cyanosis
• Peripheral oedema and elevated jugular venous pulse in cases of cor pulmonale. 
• Barrel chest (Hyperinflation of the chest)
• Wheezing on auscultation
• Reduced breath sounds
• Hyperresonance on percussion
• Coarse crackles in inspiration

References

• COPD – Symptoms, diagnosis and treatment | BMJ Best Practice [Internet]. Bmj.com. 2019. Available from: https://bestpractice.bmj.com/topics/en-gb/7
• Mosenifar Z. Chronic Obstructive Pulmonary Disease (COPD): Practice Essentials, Background, Pathophysiology [Internet]. Medscape.com. 2019. Available from: https://emedicine.medscape.com/article/297664-overview