How is COPD Diagnosed?

COPD is usually diagnosed through lung function testing such as spirometry. A spirometry test measures how well your lungs are working. It’s a simple and painless test that can help diagnose COPD. Your doctor may order additional tests to get a more complete picture of how your lungs are functioning.

A person may have chronic obstructive pulmonary disease (COPD) but not notice symptoms until it is in the moderate stage. This is why it’s important to ask your doctor about testing for COPD if you are a current or former smoker, have been exposed to harmful lung irritants for a long period of time, or have a history of COPD in your family, such as Alpha-1 Antitrypsin Deficiency-related COPD.

Who should get tested for COPD?

If you have any of these symptoms, you may have COPD.

Anyone with the following should get tested:

  • Long-term exposure to air pollution (including smoke, dust, fumes and chemicals)
  • Chronic coughing with or without sputum
  • Wheezing
  • Shortness of breath
  • An inability to keep up with people of your own age

How can I get tested?

Start by taking our 5-question Risk Screener, then talk to your doctor about taking a spirometry test. Early screening can identify COPD before major loss of lung function occurs.

What is a spirometry test?

Spirometry is a simple, non-invasive test that is used to diagnose COPD. When you take the test, you will be asked to blow all the air out of your lungs into a mouthpiece connected to a machine known as a spirometer. The machine will calculate two numbers: the amount of air you blow out in the first second, and the amount of air you can completely blow out. These numbers are represented as FEV1 and FVC. FEV1 stands for the forced expiratory volume in the first second—the amount of air you forcefully exhaled in the first second of blowing. FVC stands for forced vital capacity—the amount of air that you exhaled in one entire breath. The FEV1 percentage predicted indicates how severe the airflow is obstructed (blocked or narrowed) in comparison with people of your age, gender, and height.

After your test is completed and the reports are sent to your doctor, you will have an opportunity to talk with your doctor about your results. You may want to ask whether you have chronic bronchitis, emphysema, or both. You may also be interested to know how severe your airflow restriction is, and whether medication may be helpful. Ask your doctor if Pulmonary Rehabilitation is an option for you. See more about Pulmonary Rehabilitation in the Learn More section of our website.

Spirometry is very helpful in both diagnosing COPD and determining the severity of your condition. There are several stages of COPD. The extent of your COPD is classified into 4 different stages that are defined by your symptoms and the results of your spirometry test. The stages do not determine how long you can expect to live, or how drastically your symptoms are affecting your quality of life. The stages are designed to help your physician decide which treatment plan is right for you. In order to determine what stage you are in, your pulmonologist, based on your symptoms, may administer one or more lung function tests.

Diffusing Capacity (DLCO)

In some instances, your doctor may order other tests to better understand what is happening in your lungs. One such test is called the diffusing capacity for lungs (DLCO). This breathing test is often performed at the same appointment as a spirometry test, but instead of measuring the amount of air your lungs can take in, it measures how well your lungs exchange oxygen and carbon dioxide. This deeper understanding of how well your lungs are working helps your doctor to create a treatment plan that best supports and manages your COPD symptoms.

Chest Imaging

Your doctor may order additional tests to see if your symptoms are caused by lung disorders other than COPD. Your doctor may also order a fast and painless imaging test such as a chest x-ray or a chest CT (high resolution computed tomography).

An x-ray can show problems including pneumonia, flattened diaphragm, enlarged lungs, air pockets called bullae, and other conditions. This test can be performed during an emergency room visit, at urgent care centers, or you may have this testing done as an outpatient at an imaging center or hospital. While an x-ray cannot provide information about lung function, it helps the doctor better understand your health condition.

A Chest CT examines your lungs in much greater detail to see if your symptoms are brought on by lung problems like a nodule (a small growth that is not always cancer), a blood clot (also called a pulmonary embolism), emphysema (damage to the air sacs in the lung), or an infection (pneumonia). Chest CT testing is often performed in outpatient imaging centers and at hospitals.

Why is it important to get tested?

Leaving symptoms misdiagnosed, untreated, or undertreated may cause them to worsen faster than if they were treated with proper medication and therapy. Many adults with COPD are incorrectly diagnosed with asthma. Providing a proper diagnosis means individuals will receive the right treatments and follow-up monitoring. There is no cure yet for COPD, but treatments are available to help individuals live better with this condition.

Understanding what is going on in your lungs can help you feel more control over your breathing.

Understanding Your Lungs

Resources and Support

The COPD Foundation offers resources such as COPD360social, an online community where you can connect with patients, caregivers and health care providers and ask questions, share your experiences and receive and provide support.