COPD Resources What is COPD? COPD Facts Causes of COPD Diagnosing COPD COPD vs. Asthma The Lungs Current Treatments Patient Information Diagnosing COPD Physicians can determine whether a patient may have COPD based on the presence of three main symptoms: chronic cough, excess mucus production, or shortness of breath. Physicians can diagnose COPD with the assistance of a device known as a spirometer, especially in the early stages of the disease before the symptoms are debilitating or even before they are recognized and acknowledged by the patient. According to the National Lung Health Education Program, all persons aged 45 or older who currently smoke or have quit smoking should have spirometric testing.[13] Spirometry can also be used to monitor progression of COPD. Testing with spirometry determines the presence and severity of the airway obstruction.[4] The test is easy to administer, takes only a few minutes to complete, and is noninvasive. It can be conducted in primary care physicians' offices that are equipped with a spirometer. Patients take a deep breath and exhale into the spirometer as hard and fast as they can for a minimum of six seconds. The spirometer is connected to a computer that records the volume of air exhaled in one second (forced expiratory volume in one second, or FEV1) and the total amount of air exhaled (forced vital capacity, or FVC). The FEV1/FVC ratio is the primary measurement in identifying an obstructive impairment of the airways.[4] Spirometry is simple, inexpensive and effective in testing for decreased lung function in past and current smokers. In fact, smokers and ex-smokers should have regular spirometric tests performed.[4] Spirometry is also effective in detecting decreased lung function in other high-risk persons, such as those with occupational exposures to dusts or chemicals.[4] Symptoms of COPD The symptoms of COPD are usually constant and can slowly progress over many years, unlike the episodic, variable symptoms of asthma. The common symptoms of COPD include: · breathlessness even after mild exertion[12]; · chronic coughing, which may or may not produce mucus[12]; · frequent clearing of the throat[1]; · chest tightness[1]; and · wheezing.[7] Because COPD is a progressive disease, patients may attribute early symptoms to aging or being out of shape. They may also believe they only have a benign smoker's cough. Although symptoms of COPD may be present earlier, people are typically diagnosed with COPD when they are older than 45 and have at least a 20 pack-year smoking history.[3] Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 (the number of cigarettes in a pack) and multiplying this figure by the number of years a person has smoked. For example, a person who smokes 40 cigarettes a day and has smoked for 10 years would have a 20 pack-year smoking history (40 cigarettes per day ÷ 20 cigarettes per pack = 2; 2 x 10 years of smoking = 20 pack-year history). According to the National Lung Health Education Program, the symptoms of COPD develop because of airway obstruction, resulting in the lungs' inability to effectively use oxygen and remove carbon dioxide. Recognizing a persistent cough with or without mucus production as an early indicator of COPD can help prevent extensive damage to the airways.[10] COPD Exacerbations Typically brought on by respiratory tract infections, exacerbations of COPD are characterized by increased coughing and mucus production; change in mucus color; and shortness of breath, possibly with wheezing.[3] Patients may also show a decrease in FEV1 during an exacerbation.[3] On average, COPD patients experience an acute exacerbation once or twice a year.[14] However, as a patient's FEV1 falls, the frequency and severity of exacerbations increase.[15,16] Emergency room visits and hospitalization may be required for patients experiencing exacerbations. In 1997, there were approximately 13.4 million physician office visits and more than 600,000 hospitalizations for COPD.[2]		A chronic cough is a symptom of COPD.