FeatureObstructive Lung DiseaseRestrictive Lung Disease
Pathophysiology↑ Airway resistance. Problem getting air OUT.↓ Lung compliance/expansion. Problem getting air IN.
Spirometry - FEV1↓↓
Spirometry - FVC or Normal↓↓
FEV1/FVC Ratio< 0.7 (Hallmark finding)> 0.7 (Normal or Increased)
Total Lung Capacity (TLC) (due to air trapping) (due to impaired filling)
Flow-Volume LoopConcave, “scooped-out” expiratory limbShrunken loop, normal shape but smaller
Common ExamplesCOPD (Chronic Bronchitis, Emphysema)
Asthma
Bronchiectasis
Interstitial Lung Disease (e.g., IPF, Sarcoidosis)
Chest Wall Disorders (Kyphoscoliosis, Obesity)
Neuromuscular Disease (ALS, Guillain-Barré)
Clinical FindingsWheezing, prolonged expiration, pursed lips, barrel chest (COPD)Dyspnea on exertion, fine inspiratory (“Velcro”) crackles