Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) is suspected in patients with a history of smoking, occupational and environmental risk factors, or a personal or family history of chronic lung disease.

Presents with shortness of breath, wheeze, cough, and sputum production.

Diagnostic tests include pulmonary function tests, chest x-ray, chest computed tomography scan, oximetry, and arterial blood gas analysis.

Patients should be encouraged to stop smoking or occupational exposure and be vaccinated against viral influenza and Streptococcus pneumoniae.

Treatment options include bronchodilators, inhaled corticosteroids, phosphodiesterase-4 inhibitors, antibiotics, and mucolytics. Pulmonary rehabilitation improves exercise tolerance, dyspnoea, and health-related quality of life, and reduces re-hospitalisations and mortality.

Long-term oxygen therapy improves survival in severe COPD.

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disease state characterised by chronic respiratory symptoms and airflow limitation that is not fully reversible. It encompasses emphysema, bronchiolitis, and chronic bronchitis. The airflow limitation is often progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases. It is primarily caused by cigarette smoking. Although COPD affects the lungs, it also has significant systemic consequences. Exacerbations and comorbidities are important contributors to the overall condition and prognosis in individual patients.[1]Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2025 report. 2025 [internet publication]. https://goldcopd.org/2025-gold-report