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To find out if you have chronic obstructive pulmonary disease (COPD), your doctor will look at these things:

• If you smoke
• If you work with harmful gases or chemicals
• Your symptoms
• Your health now (you'll have a physical examination)
• Your health in the past and any health problems in your family (this is your medical history)
• Results from tests that measure how well your lungs work.

To find out if you are at high risk of having COPD, your doctor will ask whether you smoke now or whether you did in the past. Nearly everyone who has COPD is a smoker or used to smoke. But some people have inhaled only secondhand smoke.

Information about where you work and what you do will help your doctor know how likely it is that you have this disease. Your doctor will also ask about your symptoms and about any other illnesses you've had.

He or she will examine you and listen to your chest to see how well you are breathing and if you have any signs of a chest infection.

Here are some questions your doctor may ask.

• Do you cough every day? How often?
• How long have you been coughing like this?
• Do you cough up mucus (also called phlegm)? What does it look like?
• Do you feel out of breath a lot? What makes you feel breathless?
• Do you get a lot of chest infections?
• Are you losing weight?
• Does anyone in your family have chronic bronchitis? Emphysema? COPD? Any other breathing problem?
• Have you had, or do you have, heart trouble or lung problems of any kind? Do you have any other illnesses?
• Are your symptoms affecting your work, sleep, leisure or other everyday activities?

To see how healthy your lungs are, your doctor may need to do some of the tests listed below.

• Spirometry: This helps to find out how well your lungs work by measuring how much air you can breathe in and out (see Spirometry to find out more). You may have this test in your doctor's office or you may need to see a specialist.
• Walking test: This will measure how fast you get out of breath.
• Chest X-ray: An X-ray will usually show whether you have (or don't have) any other lung diseases.
• Electrocardiogram (ECG or EKG) or echocardiogram ("echo"): These tests will tell the doctor if your heart is not beating or pumping properly and if this is making you breathless.
• CT scan: Your doctor may want to do a CT scan to get a more detailed picture of your lungs.
• A blood test to measure blood gases: This shows how much oxygen and carbon dioxide you have in your blood. See Blood gases to find out more.

You can have COPD that's pretty mild, a little worse or very bad. If it looks as if you might have COPD, your doctor will give your illness a grade to show how mild or severe it is. The grade helps your doctor decide what treatment you need.¹

There are four grades, and the table below shows what they are and what each one means. If your doctor gives your illness a 0, it means you might get COPD, but you don't actually have the disease yet. The highest grade, 4, means you have COPD and it's very serious.

You'll see one abbreviation in the table below: FEV 1. This measurement is used in spirometry tests. It stands for forced expiratory volume in one second. It shows how much air you can blow out in the first second of the test.

To grade your COPD, doctors look at your FEV1 score. This gives them a percentage that helps them find out how well your lungs are working. To learn more, see Spirometry.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.