ABSTRACT
CONTENTS Clinical history: symptoms Productive cough Exertional dyspnea Miscellaneous symptoms Atypical symptoms Exposure to risk factors Physical examination: signs Pink puffers and blue bloaters Types of breathing Breath sounds Heart sounds Chronic respiratory failure Acute respiratory failure Cor pulmonale Pulmonary artery hypertension Thromboembolic disease Cachexia with nutritional depletion and muscle weakness/wasting Sleep disorders Differential diagnosis of COPD Cigarette smoke-induced COPD α1-Antitrypsin deficiency Primary ciliary dyskinesia Asthma Congestive heart failure Ischemic heart disease Bronchiectasis Tuberculosis Obliterative bronchiolitis Diffuse panbronchiolitis Need for referral Investigations Lung function
Imaging Electrocardiography Echocardiography and esophageal cardiography Miscellaneous Natural history, stages of severity, monitoring, prognosis and death Natural history Stages of COPD severity Decline in lung function Horse-race effect Smoking cessation Prognosis Death
SUMMARY Chronic obstructive pulmonary disease (COPD) generally follows decades of heavy cigarette smoking, although other risk factors may be present, especially the burning of biomass fuels in developing countries (Figure 3.1).
