Chronic bronchitis history and symptoms

Chronic bronchitis is defined clinically as persistent cough that produces sputum (phlegm), for at least three months in two consecutive years. Bronchitis may be indicated by an expectorating cough (also known as a productive cough, i.e. one that produces sputum), shortness of breath (dyspnea) and wheezing. Occasionally, chest pains, fever, and fatigue or malaise may also occur.^[1]

• The hallmark of chronic bronchitis is dyspnea. A positive history of chronic productive cough and shortness of breath is suggestive of chronic bronchitis. Some patients describe the dyspnea as air hunger because of sensation of gasping for air.^[2]

• Productive cough with gradual progression to intermittent shortness of breath.^[3]
• Sputum may contain blood (hemoptysis), usually due to damage of the blood vessels of the airways.
• An acute exacerbation may present as productive cough or an acute chest illness.
• The cough typically is worse in the mornings and produces a small amount of colorless sputum.
• The frequency and severity of acute exacerbation usually increases as the disease progresses.
• In later stages progressive cardiac/respiratory failure may present with edema and weight gain.

• Chest discomfort
• Fatigue
• Fever (typically low-grade)
• Wheezing

• In extreme cases it could lead to cor pulmonale due the extra work required by the heart to get blood to flow through the lungs which may present as:
  • Chest discomfort (typically in the front of the chest)
  • Exercise intolerance
  • Shortness of breath
  • Swelling of the feet or ankles
  • Symptoms of underlying disorders (wheezing, coughing)
• Cyanosis (typically in the lips and fingers) caused by hypoxemia
• Patient may have confusion indicating an alteration of mental status
• Depression may be seen
• Decreased fat-free mass
• Impaired systemic muscle function (systemic manifestation)

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