Chronic obstructive pulmonary diseases conundrums

Research output: Chapter in Book/Report/Conference proceedingChapter


Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality worldwide. Clinicians and researchers have only recently recognized the disease heterogeneity and systemic consequences from tobacco smoking in aging COPD patients. Diagnosis and management of COPD and its acute exacerbations that begin to occur regularly after FEV1 has declined to less than 40-60% of predicted is a conundrum encountered frequently in clinical practice. Perhaps the most important challenge is the need to diagnose COPD in earlier stages, beginning in the fifth decade of life, at least a decade before the -familiar albeit terminal phenotypes of chronic bronchitis (blue bloater) and emphysema (pink puffer) emerge. Persisting poor exercise tolerance despite the use of bronchodilators and inhaled corticosteroids should alert the clinician to the presence of co-morbidities associated with COPD, especially those that resemble acute exacerbation. COPD can often present as conundrums, singularly or severally in a patient. Thus enhancing the knowledge, skills and professional performance of an integrated COPD health care team to provide comprehensive COPD management may improve patient outcomes via early treatment and/or prevention of -serious complications secondary to COPD.

Original languageEnglish (US)
Title of host publicationChallenging Cases in Pulmonology
PublisherSpringer New York
Number of pages23
ISBN (Print)9781441970985, 1441970975, 9781441970978
StatePublished - Nov 1 2012


  • Asthma-COPD overlap syndrome
  • Chronic bronchitis
  • Chronic cough
  • COPD
  • Disproportionate pulmonary hypertension
  • DLco
  • Obstructive sleep apnea
  • Pulmonary embolism
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Medicine(all)


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