Can a low FEV1/FVC indicate COPD in a patient with a cough?

Question

Hello doctor,

I had my first appointment with a new pulmonologist today. I presented with a productive (clear) cough which I have had for two weeks. I am very frightened by them and I am terrified that I have chronic obstructive pulmonary disease (COPD), as it seems to appear from the numbers. The doctor was very non-committal about it, gave me a Breo inhaler and said to come back in a month. Forced expiratory volume (FEV)1 is only 71%. And can you explain a percentage predicted the result for the FEV1/FVC (Forced vital capacity) value? It seems to me that the report is stating that my percentage is only 58%. Is this low value dangerous? I am terrified right now. Please see the enclosed report and give your impression.

Answer 1

Hello,

Welcome to icliniq.com. Percentage predicted means how much is your observed value to the expected value. The computer predicts based on your height, age and gender and on equations how much your FEV1 (forced expiratory volume) and FVC (forced vital capacity) values should be if you are normal. Then in the test we calculate how much are your actual values. To say as normal in FEV1 and FVC we want your calculated value to be not less than 80 percent of your expected. That is 80 % predicted. Here your FEV1 is 71% percentage predicted. As per values it suggests COPD (chronic obstructive pulmonary disease). But few observations, 1. This test is not very reliable as your graph picture shown on right hand side is not an acceptable one. So I personally would like to repeat it. 2. I do not see a bronchodilator reversibility test here, which is a must to see if it is asthma. 3. If you were a smoker and have symptoms I would suggest a repeat test with bronchodilator reversibility to get a definitive diagnosis.