Requires a cooperative patient Meet American Thoracic Society
standards Asthma COPD Vocal cord dysfunction SPIROMETRY
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FEV must improve by 12%
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Asthma and COPD What do they have in common? Airway obstruction
Lowers FEV1 Leaves the total amount of air blown out unchanged
(FVC) FEV/FVC ration falls to < 70% 12% improvement in FEV
suggests asthma SPIROMETRY
Measures carbon monoxide diffusion Low Any pulmonary vascular
disease pHTN, CHF, PE Any parenchyaml destructive disease (COPD or
ILD) High Fresh hemoglobin in the alveoli DIFFUSION CAPACITY
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IMPULSE OSCILLOMETRY
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EXHALED NITRIC OXIDE
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THIS OFFICIAL CLINICAL PRACTICE GUIDELINE OF THE AMERICAN
THORACIC SOCIETY (ATS) WAS APPROVED BY THE ATS BOARD OF DIRECTORS,
MAY 2011
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DYSPNEA PFT/FVL/NO OSCILLOMETRY METHACHOLINE THORACIC US ECHO
OR CT IMAGING