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Lung India. 2019 Jan-Feb;36(1):38-47. doi: 10.4103/lungindia.lungindia_145_18.

Physical signs in patients with chronic obstructive pulmonary disease.

Author information

1
Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
2
Department of Cardiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
3
Department of Medical and Pediatric Oncology, GCRI, Ahmedabad, Gujarat, India.
4
Department of Pathology, University of Pennsylvania, Philadelphia, PA, USA.

Abstract

We reviewed the various physical signs of chronic obstructive pulmonary disease, their pathogenesis, and clinical importance. We searched PubMed, EMBASE, and the CINAHL from inception to March 2018. We used the following search terms: chronic obstructive pulmonary disease, physical examination, purse-lip breathing, breath sound intensity, forced expiratory time, abdominal paradox, Hoover's sign, barrel-shaped chest, accessory muscle use, etc. All types of studies were chosen. Globally, history taking and clinical examination of the patients is on the wane. One reason can be a significant development in the field of medical technology, resulting in overreliance on sophisticated diagnostic machines, investigative procedures, and medical tests as first-line modalities of patient's management. In resource-constrained countries, detailed history taking and physical examination should be emphasized as one of the important modalities in patient's diagnosis and management. Declining bedside skills and clinical aptitude among the physician is indeed a concern nowadays. Physical diagnosis of chronic obstructive pulmonary disease (COPD) is the quickest and reliable modalities that can lead to early diagnosis and management of COPD patients. Bedside elicitation of physical signs should always be the starting point for any diagnosis and therapeutic approach.

KEYWORDS:

Accessory muscle use; Hoover's sign; barrel-shaped chest; chronic obstructive pulmonary disease; physical examination; purse-lip breathing

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