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ABP Live Doc Talk: Asthma Or Something More? Know Why COPD Is Commonly Misdiagnosed

Asthma and COPD share similar symptoms, often leading to misdiagnosis. Experts highlight the importance of early evaluation and accurate testing for better long-term outcomes.

ABP Live Doc Talk: Most of the patients come into the clinic with complaints of asthma, particularly when they have chronic cough, breathlessness, or wheezing. From a doctor's perspective, a main challenge may be that such symptoms often intersect with COPD-a progressive disease that could be hiding behind what seems to be ordinary airway inflammation. Since asthma is better known and most often diagnosed at a younger age, patients and even doctors may assume asthma is the cause and unknowingly delay proper detection of COPD.

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Subtle And Slow Progression of COPD

One of the major reasons for misdiagnosis is its subtle development. Unlike asthma, which may involve sudden flare-ups and marked variability in symptoms, COPD often progresses very slowly, with patients adapting to early signs or attributing them to aging, pollution, or a history of smoking. Many people may not recognize their shortness of breath when performing activities of daily living, or frequent respiratory infections, as symptoms of something chronic.

By the time they come to seek medical care, symptom patterns may have markedly resembled asthma if a proper and adequate evaluation is not done. This gradual adaptation frequently results in one-to-many years of missing symptoms, which fosters a false sense of normalcy for the patient. We as clinicians note that not only does this delay hamper diagnosis, but it also restricts opportunity for early intervention, reaffirming the importance of awareness and timely assessment for productive long-term outcomes.

Overlapping Features That Complicate Diagnosis

Another situation that complicates being able to accurately diagnose asthma or COPD (chronic obstructive pulmonary disease) is that they have overlapping features. Wheeze, chest tightness, or cough is common in many cases of asthma, however these symptoms are also common in COPD, especially in a patient with a long history of smoking or chronic exposure to dust or pollution. The testing and dx process becomes more complicated in all patients because without spirometry/lung function testing it may be easy to auto-diagnose that they have asthma rather than COPD, especially of early or mild disease where symptoms are intermittent.

We stress the importance of thorough history and examination taking into consideration all variables, especially in the adults, those over 40 years of age, or those with prolonged exposure to environmental irritants. We never want to miss the opportunity for an appropriate dx, and a thorough history and exam plus the appropriate dx studies, it is easy to differentiate between asthma, COPD, or maybe even both present. An early and correct diagnosis is important with COPD b/c treating COPD will require long-term management strategies not just a standard asthma plan of care. 

The Importance Of Early And Accurate Diagnosis

Ultimately, this conversation is important in addressing the differences of asthma and COPD to promote patients receive the correct treatment at the correct time. The goal should always be the patient's comfort, and quality of life. Awareness of their condition, appropriate evaluation, and the right medical attention can greatly enhance the patient's quality of life, and possibly prevent complications that could be avoided.

Disclaimer: The information provided in the article is shared by experts and is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.

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About the author Dr. Sarat Kumar Behera

Dr. Sarat Kumar Behera is the Director Critical Care & Senior Consultant - Pulmonology at Manipal Hospital, Bhubaneshwar

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