Barrel-chested: increased AP diameter
Dyspneic with prolonged expiration
Sitting forward in a hunched-over position to squeeze air out of the lungs
Hyperventilation is prominent, so blood gas values are relatively normal- aka pink puffers
Others with mixed chronic bronchitis and a history of recurrent infections show less prominent dyspnea and respiratory drive, so they retain carbon dioxide, become hypoxic, and are often cyanotic- aka blue bloaters
Secondary pulmonary hypertension develops in both types due to hypoxia-induced pulmonary vascular spasm ( HPV)
Major causes of death:
Type II respiratory failure
Cor pulmonale.
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