An unusual case of 'exacerbation of COPD'.

A 66 year old man who had been diagnosed with COPD 18 months earlier was readmitted with breathlessness unresponsive to bronchodilators and steroids. His symptoms were noticeably improved by lying on his left side. CTPA showed no evidence of pulmonary embolism but raised the possibility of tracheomalacia, which was later confirmed with bronchoscopy and lung function testing. The classification and treatment options for tracheomalacia are discussed.