Barrel chest and blue blood
6. A barrel chest
One informal test that some doctors use to check for COPD progression is to have you breathe while raising your arms over your head. Why? They're looking for a change known as "barrel chest," which describes a particular posture and body shape that tends to develop as a secondary symptom of COPD.
As a result of chronic inflammation, the lungs become enlarged and push the diaphragm downward, which makes it harder for the diaphragm to contract as efficiently. The chest wall becomes enlarged as well, weakening muscles in the chest, neck, and between the ribs; these are known as the "accessory respiratory muscles." When this happens, people with COPD unconsciously try to compensate by leaning forward when sitting, with their arms on their knees or in front of them. This posture stabilizes the upper chest and shoulders, making it easier to use the accessory breathing muscles.
7. A bluish tinge to lips or fingernails
Over time, if your blood doesn't circulate enough oxygen throughout your body, your lips and fingernails can take on a blue or gray tone. Sometimes the color, known as cyanosis, is most apparent in the nail beds; some people develop an overall grayish-blue tinge to the skin. The cause: Oxygen-rich blood is bright red, while blood with less oxygen turns dark and bluish-colored.
In dark-skinned people, the discoloration is most visible in the lips, gums, and around the eyes, and it can be easier to spot. Cyanosis usually occurs when oxygen levels in the blood drop below 90 percent. A doctor can check this for you; you can also monitor it yourself using a finger pulse oximeter, available in medical supply stores.