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INTRODUCTION Patients with chronic pulmonary obstructive disease (COPD) are at risk of acute exacerbation. Diaphragm muscle is classically highly solicited in COPD exacerbation. PATIENT CONCERNS A COPD patient was admitted because of acute dyspnea with wheezing. DIAGNOSIS acute COPD exacerbation. INTERVENTIONS A diaphragm ultrasound and a Doppler echocardiography were performed at bedside. OUTCOMES We measured diaphragm thickening at the apposition zone and diaphragm inspiratory motion from the subcostal view, in addition with classica