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