Differential Diagnosis of Asthma and COPD

Don’t mix COPD with Asthma! This is a life-threatening disease; be aware of its differences and available treatment alternatives!

Of these potential differential diagnoses, asthma is the most difficult to determine. As we have learned, COPD and asthma are 2 distinct clinical conditions, yet there are significant overlaps in signs and symptoms between the 2 diseases. Characteristics of asthma include:

  • episodic attacks involving specific, rather than chronic, symptoms
  • some pattern in the attacks related to climate changes, emotional changes, season, or exercise
  • nonproductive cough during the attack but coughing up mucus plugs after the attack
  • wheezing during expiration
  • use of accessory muscles when breathing
  • hyperinflation of the chest

In diagnosing COPD, medical history generally reveals a strong history of smoking. In contrast, among patients with asthma, the clinician looks for signs of an atopic disorder, such as a personal or family history of allergies and specific triggers of the attacks. The major risk factors related to asthma are parental (the child of an asthmatic mother has a 7-fold increase in risk of developing asthma) and atopy (responsible for a