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Chronic Obstructive Pulmonary Disease (COPD) (cont.)

What are the signs and symptoms of COPD?

Most people with COPD have smoked at least 10 to 20 cigarettes per day for 20 or more years before experiencing any symptoms. Thus, COPD is typically not diagnosed until the fifth decade of life (in people aged 40 to 49 years).

Common signs and symptoms of COPD are as follows:

  • A productive cough or an acute chest illness is common. The cough is usually worse in the morning and produces a small amount of colorless sputum.
  • Breathlessness or being short of breath (dyspnea) is the most significant symptom, but it does not usually occur until the sixth decade of life (in people aged 50 to 59 years).
  • Wheezing is a musical, whistling, or hissing sound with breathing. Some people may wheeze, especially during exertion and when their condition worsens.
  • Often people feel like they have frequent "colds" or "pneumonia." Many hospitalizations for pneumonia often turn out to be exacerbations of COPD.

The following may occur as COPD worsens:

  • Intervals between acute periods of worsening of dyspnea (exacerbations) become shorter.
  • Cyanosis (discoloration of the skin) and failure of the right side of the heart may occur.
  • Anorexia and weight loss often develop and suggest a worse prognosis.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) Program began in 1998 with revisions in 2001, 2006, 2010, and most recently, 2014. This worldwide group has attempted to standardize the nomenclature and treatment recommendations for COPD. Their staging system is as follows; all patients have an FEV1/FVC ratio of <70%

  • Stage I is FEV1 of equal or more than 80% of the predicted value.
  • Stage II is FEV1 of 50% to 79% of the predicted value.
  • Stage III is FEV1 of less than 30% to 49% of the predicted value.
  • Stage IV is FEV1 <30% of predicted value or FEV1 <50% of predicted value plus respiratory failure, sometimes termed "end stage" COPD.
Medically Reviewed by a Doctor on 12/29/2015

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