Diagnosis Of COPD

Chronic Obstructive Pulmonary Disease or COPD is a progressive chronic disease of the lungs that has no cure. It is essential to diagnose the symptoms of COPD because leaving them untreated or misdiagnosed can worsen the condition. The treatment can only slow down the progress of the disease. Appropriate diagnosis will lead to the suitable treatment needed to manage and control the symptoms. There is no single test to confirm the diagnosis of COPD.

Though there is no cure for COPD, treatments are available, to help a person suffering from COPD to lead a better life. Often, people might not recognize or experience COPD symptoms in the initial stage of the disease. As COPD is a progressive disease, the symptoms worsen over time. It is not until later that these symptoms become unavoidable, and that is when a person might consider going through diagnosis. A person must not wait until the symptoms get worse, because times are valuable for treatment and with early diagnosis, it is possible to slow down the progression of the disease quickly.

Who Should Get Tested?

Anyone with age ≥40 years and following symptoms must consider getting tested for COPD:

• Long-term exposure to irritants such as smoke, fumes, chemicals, air pollution, biomass smoke (chulha smoke) etc.
• Chronic, productive coughing
• Wheezing
• Shortness of breath (Dyspnea)
• Chest tightening

Also, if a person has a family history of COPD or is a smoker, it is important to get tested. To diagnose COPD or the two diseases under it, chronic bronchitis and emphysema, the doctor may ask some questions. The doctor needs to gain information about the causes and symptoms of the condition, which will help in diagnosing the disease. Here are a few questions the doctor may ask:

• If there is any history of smoking
• What are the symptoms experienced and how often
• In what situation and what time do the symptoms occur or worsen
• If there is a family history of any lung diseases
• Can recommend few, simple breathing tests
• If the person has exposed to chemicals, dust, or fumes for a long-term
• If coughing is chronic and there is an excess of mucus secretion

Tests for Diagnosing COPD

After a series of these questions, a thorough physical examination, and recording the medical history, the doctor may recommend some tests to confirm the diagnosis ofCOPD. Mentioned below are the various tests available for COPD diagnosis:

• Spirometry- This is an easy test that can help in confirmation of COPD. A device called spirometer is used for this test. A person is asked to blow out all the air from his lungs, into the mouthpiece of the spirometer. This test measures the amount of air a person can blow out in the first second, and the amount of air a person can completely blow out of his or her lungs. These two numbers are denoted as Forced Expiratory Volume (FEV1) and Forced Vital Capacity (FVC), respectively. A spirometry test can also help to determine the severity of COPD. The results are compared to other people’s results of the same, age, gender and height.
• Peak Flow Test - A peak flow test can help to measure how quickly a person can blow air out of the lungs. This test is often also used for the diagnosis of asthma. This test is done with the help of a peak flow meter. It requires, blowing as hard as possible into the peak flow meter. A person must repeat this process three times, and the highest of the three readings is considered to be the personal best.
• Chest X-Ray - A chest X-ray can be done to detect any problem in the lungs, which might have caused symptoms that are similar to COPD. A chest X-ray can help to identify lung cancer or chest infections. It can show changes in the lungs, or identify any complication that stems from heart-related problems. Images of an X-ray might not confirm the diagnosis of COPD if the disease is in the initial stage, but it may show flattened diaphragm, enlarged lungs or air pockets(bullae).
• CT Scan - A chest computed tomography or a CT scan, is helpful in COPD diagnosis and it can determine if the disease is worsening. It can help to identify changes occurring due to COPD such as enlarged arteries of the lungs. This test will also help to know if a person is suffering from emphysema, and at an earlier stage as compared to an X-Ray. It is sometimes used to measure the severity of emphysema within the lungs. The images of a CT scan can further help to know if the symptoms are caused due to any other condition of the heart or lungs.
• Blood Tests – A blood test can identify other condition such as iron level (anaemia) or the high level of red blood cells in the blood (polycythaemia) which can be the reason for a person to experience symptoms similar to COPD.

Another important test is to know if the person has the rare genetic condition called Alpha 1 Antitrypsin Deficiency, as it might be the cause of a person being diagnosed with COPD. This is also done with a blood test.

Arterial blood gas test is done to measure the levels of oxygen and carbon dioxide. It helps to determine the severity of COPD and if oxygen therapy is needed. This is done through a blood test

• Sputum Examination – If a person is experiencing productive cough (cough with mucus) doctor can ask for a sputum test to be done. Examining the sputum helps to know the cause of symptoms. Sputum examination can help to identify lung cancer or bacterial infection. This test can be beneficial in diagnosing COPD.
• An Echocardiogram – This test is done to mainly determine if the shortness of breath is caused due to a heart problem as opposed to a lung problem. The doctor might recommend an echocardiogram (ECG or EKG). As the disease progresses the shortness of breath can lead to cardiac issues such as heart failure, heart attack and abnormal heart rhythm. An EKG can help to determine any disturbance in the heart rhythm, and it can measure the electrical activity of the heart.

Things To Keep In Mind Before COPD Diagnosis Testing

Before going for these tests, one must consult with their doctor about the medications they are currently taking. It is better to talk to the doctor, as before spirometry or EKG tests, things like, caffeine, smoking or even exercise might affect the test results. It is necessary to follow the pre-test instructions for accurate results. Some of the above mentioned tests might give results instantly, such as spirometry and peak flow test, whereas other tests may take a couple of days or a couple of weeks. Getting accurate test results is essential for diagnosing the condition and following an effective treatment plan based on test results.

The accurate results of diagnosis will further help the doctor and the patient to have a proper plan of controlling and managing the symptoms of the condition. Also, each person has different symptoms and level of severity; therefore, suitable medications are to be taken, and custom-made action plan should be formed with the doctor’s guidance. Regular reviewing and monitoring the condition becomes necessary as COPD worsens with time, and signs of the progression slowing down means that the medications are effective.