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January 25, 1995

Does the Clinical Examination Predict Airflow Limitation?

JAMA. 1995;273(4):313-319. doi:10.1001/jama.1995.03520280059041

CLINICAL SCENARIOS—DO THESE PATIENTS HAVE AIRFLOW LIMITATION?  In each of the following cases, the clinician needs to decide whether the patient has airflow limitation: In case 1, a 63-year-old man who has smoked two packs of cigarettes per day for the past 47 years presents with decreased exercise tolerance caused by shortness of breath. In case 2, a 35-year-old woman complains of coughing, wheezing, and shortness of breath every autumn. In case 3, an 18-year-old man is brought to an emergency department with extreme difficulty breathing that began earlier that evening.

WHY IS IT IMPORTANT TO DETECT AIRFLOW LIMITATION BY CLINICAL EXAMINATION?  Airflow limitation is a disorder known by many names, including airway obstruction and obstructive airways disease. Recognizing airflow limitation can lead to appropriate treatment and can yield important prognostic information. Patients with symptomatic airflow limitation may benefit by treatment with oral or inhaled bronchodilators, oral or inhaled glucocorticoids,