Clinical meaning
COPD features persistent airflow limitation from obstructive bronchiolitis and emphysema. Inhaled irritants activate macrophages and neutrophils releasing proteases (MMP-9, elastase) overwhelming alpha-1 antitrypsin. Mucus gland hyperplasia and goblet cell metaplasia cause chronic mucus hypersecretion. FEV1/FVC <0.7 post-bronchodilator confirms diagnosis. GOLD classification guides therapy.
Diagnosis & workup
Diagnostics & workup: - Chest X-ray PA and lateral (infiltrates, hyperinflation, effusions) - Thoracentesis with Light criteria for pleural effusion classification - 6-minute walk test for functional capacity assessment - Pulse oximetry and continuous SpO2 monitoring - CT chest high-resolution for interstitial/parenchymal disease - Peak expiratory flow rate monitoring for asthma - CT pulmonary angiography for PE evaluation
Risk factors: - Indoor air pollution and biomass fuel exposure - Prematurity with bronchopulmonary dysplasia history - Connective tissue disease with ILD predisposition - Obesity with restrictive physiology and OSA - Family history of alpha-1 antitrypsin deficiency - Age >65 with declining mucociliary clearance - Childhood asthma with persistent airway hyperreactivity