Clinical Manifestations

Early Symptoms

Symptoms are episodic in nature or continuous with very little response to bronchodialators. Productive cough especially on awakening which many people specially the cigarette smokers often ignore. Grayish white sputum, when infected, yellowish' sputum.

Inspiratory Crackles (Rales)

Late Symptoms

Significant physical incapacity, breathlessness even when walking on a flat surface, noticeable shortness of breath (SOB). As disease progresses in severity, symptoms are present constantly. Increased dyspnea using accessory muscles to breathe. Chronic hypoxemia leads to cyanosis. Increased pulmonary vascular resistance caused by respiratory acidosis and hypoxemia increases pressure on right heart resulting right heart failure (Cor pulmonale). The person appears stout or overweight from edema, dusky skin. Rt. Side heart failure may be indicated by jugular venous distention, hepatomegaly, peripheral edema. Respiratory acidosis, hypoxemia, polycythemia, tachycardia, cynosis.

Chronic bronchitis complicated by corpulmonale often have chronic respiratory failure (gradual onset of PaO,< 50, and PaCO,> 50) may develop acute respiratory failure.