Diagnosing COPD at BIDMC

Symptoms, risk factors and test results can help doctors determine if you have chronic obstructive pulmonary disease (COPD).

COPD Symptoms and Risk Factors

Many patients may not notice the symptoms of COPD in its early stages, as the disease can develop over a long period of time without a person experiencing shortness of breath. If you experience any of these symptoms or are at risk for COPD, it is important to talk with your doctor right away.

  • A cough with mucus production that does not go away
  • Shortness of breath and increased breathlessness
  • Chest tightness and wheezing
  • A history of smoking
  • Frequent exposure to lung irritants such as secondhand smoke, cleaning chemicals and other pollutants
  • A family history of COPD

Types of COPD

Emphysema and chronic bronchitis are the two most common forms of chronic obstructive pulmonary disease. Some cases of COPD have also been linked to genetics.

Diagnostic Tests

Pulmonary (lung) Function Tests (PFTs)

The most common lung function test is spirometry, a painless procedure. Patients blow into a tube attached to a machine to measure the amount of air the lungs can hold and how long it takes to exhale. Spirometry can often detect COPD before symptoms begin.

Blood Tests

Lungs bring oxygen into the blood and remove carbon dioxide. Blood tests measure levels of oxygen and carbon dioxide to determine if the lungs are working properly. Doctors may also order blood tests to assess nicotine levels, and to check levels of the Alpha-1 Antitrypsin protein (AAT). People with low levels of AAT are at risk for lung diseases such as emphysema.

Chest X-ray and CT Scan

Doctors order X-rays or scans for detailed images of the lungs, and to rule out heart failure or other lung problems. These diagnostic procedures are essential and the doses administered are reduced to the absolute minimum so as not to harm the patient. A CT scan can also help determine how widespread COPD is, and if a patient might benefit from a lung volume reduction procedure or other procedure.

Additional tests may include an echocardiogram (an ultrasound test to check heart structure and function); cardiopulmonary exercise testing (on a bike or treadmill to assess how well the heart and lungs work together); or a sleep study (to assess COPD-related sleep disturbances).

Multidisciplinary Case Conference

Specialists in our COPD Clinic review test results in a team case conference, and then together create an individualized treatment plan. The conference includes physicians and specialists from general pulmonology, interventional pulmonology, thoracic (chest) surgery, thoracic radiology, palliative (comfort) care, and pulmonary rehabilitation. Our team approach among different specialists helps ensure precise diagnosis and treatment, and well-coordinated care for our patients.