Evaluation of chronic obstructive pulmonary disease or COPD begins with a medical history and physical examination.

Physical findings in those with COPD may include:

• Cyanosis
• Low blood oxygen levels
• Wheezing
• Signs of severe difficulty breathing
• Rib retractions
• Nasal flaring
• Use of accessory muscles
• Rapid respiratory rate

The diagnosis of COPD is usually confirmed through testing.

Tests that may be used to evaluate COPD include:

• Chest x-ray
• Arterial blood gas
• Pulse oximetry
• Pulmonary function tests with response to bronchodilator medications
• Peak flow measurement in COPD
• Bronchoscopy
• Allergic skin testing (in the case of allergic asthma)
• CT scanning of the chest