Emphysema occurs as a result of increased compliance of the lung tissue. After a prolonged period, hyperventilation becomes inadequate to maintain high enough oxygen levels in the blood. Symptoms commonly reflect this.

Symptoms include:

• Shortness of breath on exertion (typically when climbing stairs or inclines, exercise intolerance and later at rest)
• Hyperventilation
• Expanded chest

• 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, usually in the front of the chest
  • Shortness of breath
  • Swelling of the feet or ankles
  • Symptoms of underlying disorders (wheezing, coughing)
• Cyanosis (bluish decolorization usually in the lips and fingers) caused by a lack of oxygen in the blood
• Patient may have confusion indicating an alteration of mental status.
• Depression may be seen
• Decreased fat-free mass, impaired systemic muscle function (systemic manifestation)

The most helpful information in diagnosis of COPD is provided by a combination of the following 3 signs ^[1]

• Self-reported smoking history of more than 55 pack-year

• Wheezing on auscultation

• Self-reported wheezing.