There is a history of recurrent mucopurulent cough with expectoration. This is often of long duration. The strain on the heart is greater in this disorder. The back pressure creates cardiac or, more often, cardio-respiratory failure. Carbon dioxide levels are high.
Hypertension develops in the pulmonary vessels.
This is associated with varying degrees of wheezing and cough. Chronic hyperventilation and exertion of breathing keep the chest constantly elevated, giving the appearance of a puffed-up chest. The increased effort in breathing is due to deficient elastic recoil of the lungs which retain air and become over-distended. The diaphragm is always kept in the lowest possible position. The constant struggle often tires the patient.