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Presenting features of acute exacerbations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Exacerbations in patients may differ widely. Some patients may have mild episodes which are usually managed at home while some may face life-threatening events necessitating ventilatory support and a prolonged hospital stay (1)

There is no single defining symptom of an exacerbation.

  • worsening of previous stable condition
  • increased wheeze
  • increased dyspnoea
  • increased sputum volume
  • increased sputum purulence
  • chest tightness
  • fluid retention
  • reduced exercise tolerance
  • increased fatigue (1)

Chest pain and fever are uncommon and if present should prompt a search for other aetiologies (1).

The following signs can be considered as signs of a severe exacerbation:

  • marked dyspnoea
  • tachypnoea
  • purse lip breathing
  • use of accessory muscles (sternomastoid and abdominal) at rest
  • acute confusion
  • new onset cyanosis
  • new onset peripheral oedema
  • marked reduction in activities of daily living (2)

Reference:

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