Diagnosis of COPD

The first step in diagnosing COPD is a good physical evaluation. A doctor will conduct a complete physical exam and ask you questions about your lifestyle including your family, your job, your habits, your hobbies, your current medications, and your symptoms.

Following the evaluation may be a number of tests to evaluate your breathing and other aspects of your health. These tests may be necessary because other diseases and/or disorders can be confused with COPD. 

 

Breathing, Exercise, and Oxygen Tests

Pulmonary function testing measures how well you are breathing. There are different types of breathing tests that can be done during pulmonary function testing. The results of pulmonary function testing can help your doctor find the best treatment plan for you.

• Spirometry: A spirometry test measures airflow into and out of the lungs. This indicates whether or not there is airway obstruction. Spirometry test results are useful in making the diagnosis of a specific lung disorder. Even more important, yearly spirometry measurements help to detect lung disease at an early stage when lifestyle changes and treatment may help forestall future problems.

• Arterial Blood Gas Testing: Arterial blood gas is a blood sample test ordered by your physician to evaluate measurements of oxygen level, carbon dioxide (effectiveness of respiration), and several other parameters. Generally, it is indicated when your physician needs to evaluate the effectiveness of your breathing.

• Bronchial Provocation Test: The bronchial provocation test evaluates how sensitive the airways in your lungs are. A spirometry breathing test is done before and after you inhale a spray such as methacholine. The spirometry results are compared before and after you inhale the spray to see what changes there are in your breathing.

• Exercise Tolerance Testing: The exercise tolerance test evaluates the ability of your heart and lungs to provide oxygen and remove carbon dioxide from the bloodstream before, during and after you exercise.

• Exercise for Desaturation Testing: The exercise for de-saturation test evaluates your oxygen needs at rest and during exercise.

 

X-Rays and CT (CAT) Scans

• X-rays: X-rays can show irregularities or damage in the lungs caused by COPD and other chronic lung diseases.

• CT Scan of the Chest : A CT or CAT scan is a shortened name for computerized tomography. During a CT scan of the chest pictures are taken of cross sections or slices of the thoracic structures in your body. Thoracic structures include your lungs, heart and the bones around these areas.

• CT Scan of the Sinuses : During a CT scan of the sinuses pictures are taken of cross sections or slices of the sinuses. The sinuses are air-filled cavities in your head. CT scans can identify problems with your sinuses. Your doctor will use this information to determine the best treatment for you.

 

Other Tests

• Bronchoscopy: A bronchoscopy allows the doctor to look inside the airways in the lungs. The bronchoscopy can be videotaped to look at later. Your doctor may also do a lavage, which involves putting a small amount of fluid into the airways, and the fluid is then pulled out with cells from the airways of your lungs. A biopsy of the airway may also be done, where a small amount of the tissue is taken from the lining of the lung. The cells and tissue can be studied closely to help determine your diagnosis and the best treatment for you.

• Mucus Culture: Some kinds of bacteria like to live in the mucus produced in the sinuses and airways of the lungs. A culture of this mucus can help identify an infection. Lung and/or sinus infections can complicate and/or mimic some symptoms of COPD.

• Bone Scan: A bone scan is a test that can identify bone that is diseased or injured. Normally, bone absorbs nutrients that are the building blocks of bone formation. If bone is diseased or injured nutrients are absorbed differently. The bone scan takes pictures of this process. A bone scan can pick up on bone disease or injury that may not be seen with a traditional x-ray.

• pH Probe Study: A pH probe study measures the amount of gastroesophageal reflux you/your child has. Gastroesophageal reflux is the backward flow or reflux of food and acid from the stomach into the esophagus. The esophagus is the tube that takes food from your mouth into your stomach. A pH probe will help identify if you have increased amounts of reflux and if it is causing you to have trouble breathing or other symptoms.

This information has been approved by Scott Van Da Walker, MSN, FNP-C (August 2006).