Symptoms of COPD

 

—  Symptoms

—  Worsening of dyspnoea

—  Cyanosis

—  Confusion

—  Examination

—  Auscultation of the chest:

—  Diminished breath sounds bilaterally

—  Mild expiratory wheezing

—  BP -140/90 mm

—  Pulse: 86/ minutes

—  RR: 25/minutes

—  Oxygen saturation 87%

—  PH: 7.43

—  Temperature 39 C

—  Pco2 – 43 mmHg

—  Po2 – 59 mmHg

—  HCO3 – 28.9 mmHg

This patient was suffering from worsening of dyspnea. COPD usually presents with difficulty in breathing along with feelings of chest tightness, cough, and increased sputum production. When exacerbation occurs, the symptom intensity increases. Furthermore, it can lead to confusion and exhaustion. More severe damage may lead to cor pulmonale (heart failure) and peripheral edema. Confusion, cyanosis and exhaustion are consequences of the reduced oxygen supply that occurs as the disease leads to decrease flow of air in the lungs. In the absence of sufficient oxygen, the body feels exhausted and tired. Additionally, when the chest of a COPD patient with advanced disease is auscultated, it typically reveals decreased breath sounds, increased percussion notes, and audible expiratory wheezes. Also, the chest becomes hyperinflated, and its expansion decreases. These findings were present in this patient.

Since oxygen saturation is < 94% on air, Arterial Blood Gas (ABG) analysis of the patient was done and it came out normal. Arterial blood gas (ABG) was done because it helps to measure the respiratory and metabolic status along with pH of the critically ill patients. However, patient’s temperature was high. Therefore, further evaluation was needed in the form of laboratory tests. The remainder of the physical examination was unremarkable.