Chronic obstructive pulmonary disease - Diagnosis

Seeing your GP

To find out if you are at high risk of having COPD, your GP will ask whether you smoke now or whether you did in the past. Nearly everyone who has COPD is a smoker or used to smoke. But some people have inhaled only second-hand smoke.

Information about where you work and what you do will help your doctor know how likely it is that you have this disease. Your GP will also ask about your symptoms and about any other illnesses you've had.

He or she will examine you and listen to your chest to see how well you are breathing and if you have any signs of a chest infection.

Here are some questions your GP may ask.

• Do you cough every day? How often?
• How long have you been coughing like this?
• Do you cough up mucus (also called phlegm)? What does it look like?
• Do you feel out of breath a lot? What makes you feel breathless?
• Do you get a lot of chest infections?
• Are you losing weight?
• Does anyone in your family have chronic bronchitis? Emphysema? COPD? Any other breathing problem?
• Have you had, or do you have, heart trouble or lung problems of any kind? Do you have any other illnesses?
• Are your symptoms affecting your work, sleep, leisure or other everyday activities?

To see how healthy your lungs are, you will need some of the tests listed below. Your GP may do some of them, or your GP may refer you to your local hospital for tests.

• Spirometry: This helps to find out how well your lungs work by measuring how much air you can breathe in and out (see Spirometry to find out more). Your doctor will use it to find out if you have COPD, and if you do have it, how bad it is.
• Walking test: This will measure how fast you get out of breath.
• Chest X-ray: This will usually show whether you have (or don't have) any other lung diseases.
• Electrocardiogram (ECG) or echocardiogram ('echo'): These tests will tell the doctor if your heart is not beating or pumping properly and if this is making you breathless.
• CT scan: Your doctor might want to use this test to get a more detailed picture of your lungs.
• A blood test to measure blood gases: This shows how much oxygen and carbon dioxide you have in your blood. See Blood gases to find out more.

Seeing a specialist

Your GP may diagnose COPD on the basis of your symptoms, examination and test results. Or your GP may prefer that a specialist makes the diagnosis. Like your GP, the specialist will ask you about your symptoms and examine you. You may have new tests or tests that you've already had. The specialist will then be able to tell you and your GP whether you have COPD.

Grading COPD

You can have COPD that's quite mild, a little worse or very bad. If it looks as if you might have COPD, your doctor will give your illness a grade to show how mild or severe it is. The grade helps your doctor decide what treatment you need.[1]

There are four grades, and the table below shows what they are and what each one means. If your doctor gives your illness a 0, it means you might get COPD, but you don't actually have the disease yet. The highest grade, 4, means you have COPD and it's very serious.

You'll see two abbreviations in the table below: FVC and FEV 1 . These are measurements used in spirometry tests.

• FVC stands for forced vital capacity. It is the total amount of air you can blow out after taking a deep breath.
• FEV 1 stands for forced expiratory volume in one second. It shows how much air you can blow out in the first second of the test.

To grade your COPD, doctors look at your FEV1 score. They also divide your FEV1 by your FVC (often written as FEV1/FVC). This gives them a percentage that helps them find out how well your lungs are working. To learn more, see Spirometry.