COPD Diagnosis
How will your healthcare provider find out whether you have COPD?
Your provider will diagnose COPD based on your symptoms, your medical and family histories, and test results.
- Talk to your provider about your smoking habits or history or whether you have had contact with secondhand smoke, air pollution, chemical fumes, or dust.
- If you have persistent shortness of breath that gets worse over time, let your provider know, because this is the main symptom of COPD.
- If you have an ongoing cough, let your provider know how long you’ve had it, how much you cough, and how much mucus comes up when you cough.
- Let your provider know whether you have a family history of COPD.
- Your provider will examine you and use a stethoscope to listen for wheezing or other abnormal chest sounds.
- Lung function and imaging tests will tell your provider whether you have COPD and how serious it is.
Spirometry
The main test for COPD is spirometry. Spirometry can detect COPD before symptoms are recognized. Your provider may also use the test results to find out how severe your COPD is and help set your treatment goals.
Spirometry is a type of lung function test that measures how much air you breathe out. It also measures how fast you can blow air out.
During the test, a technician will ask you to take a deep breath in. Then you will blow as hard as you can into a tube connected to a small machine called a spirometer. Your healthcare team may have you inhale (breathe in) medicine that helps open your airways and then blow into the tube again. They can then compare your test results before and after taking the medicine.
Some people feel lightheaded or tired from the required breathing effort.
Other lung function tests
Peak expiratory flow (PEF) test
This test measures how fast you can blow air out using maximum effort. This test can be done during spirometry or with a small handheld device.
Fractional exhaled nitric oxide (FeNO) test
Fractional exhaled nitric oxide (FeNO) tests measure how much nitric oxide is in your breath. High levels of nitric oxide may mean that the airways in your lungs are inflamed, which can make it hard to breathe.
For this test, you will breathe out into a tube that is connected to the portable device. It requires steady but not heavy breathing and has few or no risks. It is done in adults and children age 5 and older.
Arterial blood gas test
An arterial blood gas test measures the oxygen and carbon dioxide levels in your blood.
Arterial blood gas tests are usually done in a hospital but may be done in a healthcare provider’s office. For this test, blood will be taken from an artery, usually in the wrist where your pulse is measured.
Lung imaging tests
Chest computed tomography (CT) scan
A chest computed tomography (CT) scan is a painless imaging test that takes many detailed pictures, called slices, of your lungs and the inside of your chest. Computers can combine these pictures to create three-dimensional (3D) models that show the size, shape, and position of your lungs and structures in your chest.
A chest CT scan can help find the cause of lung symptoms such as shortness of breath or chest pain. It can also tell your healthcare provider whether you have certain lung problems such as a tumor, excess fluid around the lungs known as pleural effusion, or pneumonia.
Your chest CT scan may be done in a medical imaging facility or hospital. You will lie still on a table that will slide into the scanner. You will hear soft buzzing or clicking sounds when you are inside the scanner and the scanner is taking pictures. You will be able to hear from and talk to the technician performing the test while you are inside the scanner. For some diagnoses, a contrast dye, often iodine-based, may be injected into a vein in your arm before the imaging test.
In rare instances, some people have an allergic reaction to contrast dye. There is also a slight risk of cancer, particularly in growing children, because the test uses radiation. Although the amount of radiation from one test is usually less than the amount of radiation you are naturally exposed to over 3 years, patients should not receive more CT scans than what is recommended by clinical guidelines.
Chest X-ray
A chest X-ray is a fast and painless imaging test to look at the structures in and around your chest.
The test cannot diagnose COPD, but it can be used to find other conditions that may interact with COPD. The test may be done in a healthcare provider’s office, clinic, or hospital. You will stand, sit, or lie still for the test.
Chest X-rays have few risks. The amount of radiation used in a chest X-ray is very small. Talk to your provider if you are or could be pregnant.
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