Key elements:
(1) chronic cough
(2) any amount of chronic sputum production
(3) dyspnea
(4) history of exposure to risk factors
Features of cough:
(1) present intermittently or every day
(2) often present throughout the day
(3) seldom only nocturnal
Features of dyspnea:
(1) progressive, worsening over time
(2) present every day (persistent)
(3) worse on exercise
(4) worse during a respiratory infection
(5) may be described by the patient as: air hunger, gasping, heaviness, increased effort required to breathe
Historical risk factors:
(1) tobacco smoking
(2) chronic exposure to occupational dusts or chemicals
(3) chronic exposure to smoke from fires (cooking, fuel fires, etc.)
The presence of multiple indicators increase the probability of COPD but spirometry is needed to establish the diagnosis.
