Today Anne presented a fantastic case of a patient with hypoxia in clinic who carried a dx of COPD but had PFTs that were atypical for that dx (ie, no obstructive defect, but DLCO decreased to ~70%).
Goop cited an article in the NEJM within that last year that looked at COPD symptoms among patients with a smoking history who did and did not have FEV1/FVC < 0.7.
Below is the link to the NEJM “quick take” video (2 minutes, great video).
In summary, among smokers who do not have FEV1/FVC <0.7 (our typical cutoff for obstructive ventilatory defect), there are many patients who will have COPD symptoms (cough, sputum, SOB).
More evidence that COPD is a much more heterogenous disease than many of us may have learned in med school!