Which COPD phenotype is described as 'pink puffer'?

Which COPD phenotype is described as 'pink puffer'?

• A. Asthma
• B. Emphysema
• C. Bronchiectasis
• D. Chronic bronchitis

Answer: (B)

Pink puffer describes the emphysema phenotype of COPD. In emphysema, destruction of the elastic walls in the alveoli causes air trapping and hyperinflation, so breathing becomes an effortful, pursed-lip process to keep airways open during expiration. This leads to severe dyspnea with little productive cough, and patients are often thin or cachectic with a barrel-shaped chest and diminished breath sounds. Gas exchange is impaired, but oxygen levels can stay relatively normal early on, so they appear pink rather than cyanotic. A hallmark is a reduced diffusing capacity due to loss of alveolar surface area. In contrast, chronic bronchitis—the blue bloater—tends to have a productive cough with cyanosis, obesity or edema, and a normal DLCO.

Pink puffer describes the emphysema phenotype of COPD. In emphysema, destruction of the elastic walls in the alveoli causes air trapping and hyperinflation, so breathing becomes an effortful, pursed-lip process to keep airways open during expiration. This leads to severe dyspnea with little productive cough, and patients are often thin or cachectic with a barrel-shaped chest and diminished breath sounds. Gas exchange is impaired, but oxygen levels can stay relatively normal early on, so they appear pink rather than cyanotic. A hallmark is a reduced diffusing capacity due to loss of alveolar surface area. In contrast, chronic bronchitis—the blue bloater—tends to have a productive cough with cyanosis, obesity or edema, and a normal DLCO.