Patterns of disease in advanced COPD


Type A: 
Pink Puffer (Emphysema Predominant) 

Major complaint is dyspnea, often severe, usually pre- 

senting after age 50. Cough is rare, with scant clear, 

mucoid sputum. Patients are thin, with recent 

weight loss common. They appear uncomfortable, 

with evident use of accessory muscles of respiration. 

Chest is very quiet without adventitious sounds. No 

peripheral edema. 


Type B: 
Blue Bloater (Bronchitis Predominant) 

Major complaint is chronic cough, productive of muco- 

purulent sputum, with frequent exacerbations due to 

chest infections. Often presents in late 30s and 40s. 

Dyspnea usually mild, though patients may note limi- 

tations to exercise. Patients frequently overweight and 

cyanotic but seem comfortable at rest. Peripheral 

edema is common. Chest is noisy, with rhonchi invari- 

ably present; wheezes are common. 


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