Medical history and examination
A detailed medical history1 of a patient presenting with COPD symptoms should assess the following clinical symptoms of COPD:
• Patient’s exposure to risk factors
• Past medical history
• Family history of COPD/ other respiratory disease
• Pattern of symptom development
• History of exacerbations
• Presence of comorbidities
• Impact of disease on patient’s life
• Social and family support available
• Possibilities for reducing risk factors (e.g. smoking cessation)
A physical examination is rarely diagnostic in COPD as physical signs of airflow limitation are usually not present until significant impairment of lung function has occurred. A variety of physical signs may be present in COPD but their absence does not exclude the diagnosis. Spirometry is the most reproducible and objective measurement of airflow limitation available.
It is not unusual for clinical signs to be minimal or absent in a medical examination of a COPD patient.
- Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global Strategy for the Diagnosis, Management, and Prevention of COPD. 2013. www.goldcopd.org