The diagnosis of COPD is fairly straightforward and consists of:
- Breathing test (spirometry). This is the baseline test, the patient is asked to breathe into a machine which shows whether or not the airways
have narrowed. The NICE guidance says "Spirometry is fundamental to making a diagnosis of COPD and a confident diagnosis of COPD can only be made with
spirometry."
- Chest X-ray. This will show whether the lungs have over expanded.
- CT scan. This may be taken to rule out any other lung problems.
- Blood Test. A full blood test will show whther there is any anaemia and whether there is an excess of red blood cells (polycythaemia) which may mean that
the body isn't getting enough oxygen.
The NICE guidance recommends that doctors should grade the breathlessness according to the following scale:
- Grade 1. Not troubled by breathlessness except on strenuous exercise;
- Grade 2. Short of breath when hurrying or walking up a slight hill;
- Grade 3. Walks slower than contemporaries on level ground because of breathlessness, or has to stop for breath when walking at own pace.
- Grade 4. Stops for breath after walking about 100m or after a few minutes on level ground.
- Grade 5. Too breathless to leave the house, or breathless when dressing or undressing.
Doctors are encouraged to distinguish between COPD and asthma at an early stage. The main differences between the two are-
Nearly all people with COPD are smokers whereas this is not the case in people with asthma.
It is common for people under the age of 35 to have asthma whereas this is rare in people with COPD.
A chronic "productive" cough is common in people with COPD but uncommon in people with asthma.
Breathlessness is a persistent and progressive feature of COPD whereas it is variable in asthma.
Night time waking with breatlessnes and/or wheeze is common in asthma but uncommon in COPD.
Significant diurnal or day to day variability of symptoms in uncommon in COPD but a common feature of asthma.
