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ASTHMA

Overview

Asthma varies significantly in causes, age of onset, and severity. Wheezing, forceful cough, shortness of breath, and chest tightness are telltale signs.

Asthma varies in symptoms and the length of time before signs occur. Some symptoms can emerge immediately after exposure to an irritant and others could take months and even years to follow.


Here are the common signs you should look for:

  • Wheezing

  • Tight, purposeful cough

  • Shortness of breath

  • Chest tightness

 

Viral respiratory infections, particularly with respiratory syncytial virus (RSV) and rhinovirus (RV), are the most common causes of wheezing in infants and young children, and they have important influences on the development of asthma.

The "classic" signs and symptoms of asthma are intermittent dyspnea, cough, and wheezing. Although typical of asthma, these symptoms are nonspecific, making it sometimes difficult to distinguish asthma from other respiratory diseases. The definitive diagnosis of asthma requires the history or presence of respiratory symptoms consistent with asthma, combined with the demonstration of variable expiratory airflow obstruction.

Tools used in the diagnosis of asthma include history, physical examination, pulmonary function testing, and other laboratory evaluations.

Asthma may develop at any age, although the majority of people with asthma are diagnosed in childhood. Obtaining the clinical history in an adult should include questions about the presence of symptoms earlier in life. Other historic clues that are highly suggestive of asthma include recurring, episodic symptoms, the presence of typical triggers (especially exercise, cold air, or allergen exposure), and personal or family history of allergic disease.

The pulmonary function tests most helpful in diagnosing asthma are spirometry pre- and post-bronchodilator, bronchoprovocation testing (usually with methacholine), and peak expiratory flow (PEF) monitoring.

Other laboratory studies are sometimes indicated to identify potential asthma triggers and exclude alternative diagnoses, including blood tests (eg, complete blood count with white blood cell differential, total serum immunoglobulin E, and allergen-specific immunoassays), skin testing for environmental allergies, and a chest radiograph.

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