What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is the one of the 10 leading causes of death in Hong Kong, and further increases in its prevalence and mortality can be predicted in the coming decades.

COPD treatments

COPD is a common preventable and treatable disease, is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases.

An inflammation of the airways

People with chronic obstructive pulmonary disease (COPD) have inflammation of the airways, bronchi and lung tissue (chronic bronchitis).

This inflammation leads to a narrowing of the airways, preventing air from passing through easily.

Depending on the stage of the disease, the pulmonary alveoli (small air sacs in the lungs) deteriorate and are eventually destroyed: this is called pulmonary emphysema (or emphysema).

The prevalence of COPD based on spirometry test data could be as high as 12.4%-25.9% for people aged 60 and above in Hong Kong.

Symptoms of COPD

As the disease progresses over time, it can lead to symptoms such as:

  • Feeling out of breath
  • Frequent coughing
  • Saliva and mucus production (sputum)
  • Chest infections

As symptoms persist or get worse, people with COPD may be at risk of an event called an exacerbation which is a severe flare up of symptoms which may result in a hospitalization.

Frequent coughing is the most common symptom of COPD

80% of Chronic Obstructive Pulmonary Disease cases are attributed to smoking

COPD Risk Factors

Lifestyle and genetic factors may increase the risk of COPD or contribute to its worsening. These include:

  1. Exposure to tobacco smoke
  2. Long-term exposure to harmful dust, fumes, chemicals and secondhand smoke
  3. Genetics and frequent lower respiratory tract infections during childhood
  4. An unhealthy lifestyle and poor nutrition
  5. Air pollution is considered an aggravating factor, which increases the risk of an exacerbation
  6. COPD can lead to decreased physical activity and reduced exercise tolerance further aggravating the disease

How to diagnose COPD?

COPD Pre-screening Quiz

Check your risk in 30 seconds

Take this short quiz to find out if you may be at risk or experiencing signs of COPD. This pre-screening quiz is for information purposes only and should not replace a complete medical examination by a doctor. If you think you may have COPD or are worried about your health, please seek advice from medical professionals.

Questions
  1. Do you cough regularly?
  2. Do you cough up phlegm regularly?
  3. Do even simple chores make you short of breath?
  4. Do you wheeze when you exert yourself (exercise, go up stairs)?
  5. Are you a smoker, ex-smoker or exposed to second-hand smoke?
  6. Are you older than 40 years old?
  7. Have you ever had a respiratory related hospitalization?
Your Answers

If you answered YES to 3 or more of these questions = You may be experiencing symptoms of COPD.

If you answered YES 2 questions or less = You are at low risk of experiencing symptoms of COPD.

How to diagnose COPD?

Check this if you have 3 or more "YES" in the quiz

In order to diagnose COPD - which includes chronic bronchitis and emphysema - your doctor will want to meet with you to ask you a series of questions and review your medical history.

Depending on the results, they may choose to give you one of these three standard COPD tests: spirometry, arterial blood gas or pulse oximetry.

 

Spirometry

Because COPD symptoms like coughing and shortness of breath can be fairly generic and may indicate a number of different respiratory illnesses, your doctor may refer you for a Spirometry test. Spirometry is the standard and most effective method for testing and diagnosing COPD.  It may also be referred to as a pulmonary function test or PFT. These tests are designed to measure how well your lungs function and their capacity for air. This test is also effective for diagnosing respiratory diseases before symptoms may appear.

A man undertaking a spirometry test in hospital
Arterial Blood Gas

Another method for testing is called an Arterial Blood Gas test or ABG. A small amount of blood is taken from an artery (usually in the wrist) to measure the levels of oxygen and carbon dioxide in your blood. This test is very accurate and is usually required to determine if you need home oxygen therapy.

 

Pulse Oximetry

A pulse oximeter is a small device that is placed on your finger that estimates the oxygen levels in your blood. This test is simple and pain-free and is usually performed to record your oxygen levels in real-time, on the spot. This type of test may also be used for funding requalification depending on the province you live in.

8 Signs & Symptoms of a COPD Spell

1. Shortness of Breath

Increased shortness of breath, wheezing and coughing require breathing treatment. Talk to the patient’s physician for appropriate breathing exercises.

2. Increased Coughing

In a COPD spell, usual symptoms suddenly become worse. Increased coughing, with or without sputum, is a sign of the airway growing narrower.

If below symptoms appear, do not wait until the next appointment with the physician to talk about. Contact the doctor within 24 hours of changes in health.

3. Fever

Fever is not a good indicator for COPD spells because not all patients experience high fevers with spells. However, if fever is accompanied by any of the above symptoms listed, a COPD spell may be imminent.

4. Swelling in Lower Extremities

Patients with COPD often develop swelling in their ankles, feet or legs. If this happens, elevate feet immediately.

5. Sputum

Coughing up mucus-like sputum is normal.

However, sputum that becomes thicker or changes color to yellow or green, or that is blood-tinge should be reported to doctor.

6. Fatigue

Fatigue and reduced ability to exercise are only normal among patients with severe COPD. Call the doctor within 24 hours if a persistent, dramatic increase of fatigue occurs.

If below symptoms occur, call 999 immediately or send the patient to the emergency room of the nearest hospital.

7. Bluish Lips or Skin

Lips, skin, fingernails or toes with a bluish tint are called cyanosis. Cyanosis is caused by a lack of oxygen in the bloodstream. Rapid administration of supplemental oxygen by a medical professional is required.

8. Confusion or Dizziness

Sudden confusion, dizziness or extreme agitation indicate a severe COPD flare-up.

If your family member is experiencing a life-threatening emergency, such as sudden confusion, or worsened shortness of breath not relieved by prescribed medicines, call 999 or go to your nearest hospital immediately.

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