Prolonged expiration
The chest may be hyperresonant, and wheezing may be heard
Wheezing: May occur in some patients, particularly during exertion and exacerbations
Cough, usually worse in the mornings and productive of a small amount of colorless sputum
Breathlessness: The most significant symptom, but usually does not occur until the sixth decade of life
Patients may be very thin with a barrel chest
Patients may have signs of right heart failure (ie, cor pulmonale), such as edema and cyanosis
Patients may be obese
Hyperresonance on percussion
Heart sounds are very distant
Frequent cough and expectoration are typical
Patients typically have little or no cough or expectoration
Diffusely decreased breath sounds
Tachypnea and respiratory distress with simple activities
Cyanosis
Wheezing – Frequently heard on forced and unforced expiration
Peripheral edema
Use of accessory muscles of respiration is common
Hyperinflation (barrel chest)
Elevated jugular venous pulse (JVP)
Coarse rhonchi and wheezing may be heard on auscultation
Use of accessory respiratory muscles and paradoxical indrawing of lower intercostal spaces (Hoover sign)
Coarse crackles beginning with inspiration in some cases