COPD diagnosis

Because it shares symptoms with other lung conditions, COPD is commonly misdiagnosed^[18]. In order to diagnose your condition, your provider may order several tests, including:

• Lung function tests: Lung function tests measure how much air you can breathe in and out.

Spirometry is a common test that measures your lung function. In this test, you blow air through a tube attached to a small machine called a spirometer. The spirometer measures how much air you blow out and how quickly you can do so. Spirometry can help detect COPD before its symptoms develop. Your provider might also use spirometry to monitor the disease’s progression and how well treatment is working.

• Arterial blood gas analysis: This blood test measures the amount of oxygen and carbon dioxide in your blood. A high level of carbon dioxide in your blood can be a sign of poor lung function caused by COPD.
• Pulse oximetry^[19]: This test measures the level of oxygen in your blood. It is conducted through a device called a probe. The probe is clipped onto a finger or earlobe and uses light to measure your blood oxygen level.
• Chest X-ray: A chest X-ray can help support^[20] a diagnosis of COPD by showing signs such as air pockets in the lungs, enlarged lungs, or a flattened diaphragm. An X-ray can also be used to determine if another condition is causing your symptoms.
• CT scan: A CT scan is another type of imaging test that produces multiple images of the insides of your lungs. It can help identify emphysema at an earlier stage than a chest X-ray and also determine whether another condition is causing your symptoms.

COPD exacerbation

An episode in which your COPD “flares up” or suddenly worsens is called an exacerbation^[21]. COPD exacerbations can be very serious. Get medical help as soon as possible if you think you are having an exacerbation. The symptoms of a COPD exacerbation include:

• Becoming more breathless than usual during routine activities, like walking or showering
• Coughing more frequently or more severely than usual
• Coughing up more mucus
• Mucus color changing from clear to deep yellow, green, or brown
• Feeling excessively tired
• More trouble sleeping than usual
• Developing a headache or feeling confused when you wake up (these are signs of high carbon dioxide levels and require immediate medical attention)
• Lower oxygen levels than usual (if you regularly measure your oxygen level)

A lung infection is the most common cause of COPD exacerbation. Other causes include severe allergies or inhaling irritating substances due to air pollution. Exacerbations can last for days or weeks. A COPD exacerbation may require antibiotics, oral or inhaled corticosteroids, or even hospitalization. If you’ve had exacerbations before or have severe COPD, talk to your provider about how to prepare for a sudden worsening of your symptoms.

End-stage COPD

End-stage COPD refers to being in the final stages of the disease. At this stage, COPD exacerbations can be life-threatening. For patients with end-stage COPD, a lung transplant^[22] may be considered when other treatment options are no longer effective. At this stage, the goals of care change from treating the disease to providing comfort through palliative care^[23]. Palliative care seeks to relieve suffering and provide the best possible quality of life by managing symptoms that are harder to control, including dyspnea (labored breathing), fatigue, pain, anxiety, and depression.