COPD

To diagnose COPD, a provider will perform an exam and ask you about your health history. They’ll test how well your lungs work and might get images of your lungs.

They may ask you questions like:

• Do you smoke or have you ever smoked?
• Have you had long-term exposure to dust or air pollutants?
• Do other members of your family have COPD, other lung conditions or liver disease?
• Do you get short of breath with exercise? When resting?
• Have you been coughing or wheezing for a long time?
• Do you cough up phlegm?

What tests do healthcare providers use to diagnose COPD?

Your provider might use the following tests to help diagnose COPD:

• Pulmonary function tests. Providers can use spirometry and other tests to see how well your lungs are working.
• Pulse oximetry. This test uses a device on your finger to measure oxygen levels in your blood.
• Imaging tests. Chest X-rays or CT scans can look for lung changes caused by COPD.
• Arterial blood gas test. This is a blood test that checks your oxygen and carbon dioxide levels.
• Exercise testing. Your provider uses this to determine if the oxygen level in your blood drops when you exercise.
• Electrocardiogram (ECG or EKG). This test checks heart function and rules out heart disease as a cause of shortness of breath.
• Blood tests. Your provider may check your levels of the protein AAT to see if you might have Alpha-1 antitrypsin deficiency.
• Genetic testing. If your provider thinks a genetic condition could be causing your lung issues, they may check for genetic changes with a blood test.

What are the stages of COPD?

Your provider can stage COPD based on your forced expiratory volume in one second (FEV₁) results. FEV₁ is the amount of air you can breathe out in one second, and it can tell your provider how blocked your airways are. Your provider measures FEV₁ with spirometry.

COPD stages based on severity are:

• Stage 1: FEV₁ is 80 or above.
• Stage 2: FEV₁ is between 50 and 79.
• Stage 3: FEV₁ is between 30 and 49.
• Stage 4: FEV₁ is less than 30.

Your provider can also evaluate your symptoms and your risk for exacerbation using groupings with the letters A, B and E:

• A: You have mild symptoms and a low risk for exacerbations.
• B: You have more severe symptoms and a low risk for exacerbations.
• E: You have a high risk for exacerbations.

Your stage isn’t directly related to your symptoms — for instance, you could be in stage 3 or 4 but still have mild symptoms. Your provider can use your stage, symptoms and number of exacerbations to guide your treatment.