How Is Exercise Induced Asthma Diagnosed?

Question: How Is Exercise Induced Asthma Diagnosed?

Answer: In known asthma patients or patients with typical symptoms during or after exercise, your physician will often make a presumptive diagnosis of exercise induced asthma by discussing your symptoms with you. Many times your doctor will not conduct further diagnostic tests unless your symptoms persist, or they are not prevented by other measures such as taking albuterol 30 minutes before exercise.

If you do not have an asthma diagnosis but develop chest tightness, coughing, shortness of breath, or wheezing during or after exercise, further investigation by your doctor is necessary to make sure the symptoms are not due to some other condition, like heart disease.

Most often, spirometry before and after physical activity is used to confirm a diagnosis of exercise induced asthma. Generally, you will exercise on a treadmill or stationary bicycle until you reach 85% of your expected maximum heart rate. You are considered to have exercise induced asthma if your FEV1 falls more than 10% with exercise. Some asthma care providers may recommend a bronchoprovocation challenge test, but this is not specific to exercise induced asthma diagnosis. Similarly, measuring peak flows pre- and post-exercise is not recommended to diagnose exercise induced asthma, as results are often inaccurate.

Other causes of shortness of breath, chest tightness, and cough occurring with exercise also need to be considered. This is especially important if you have no other asthma symptoms and do not benefit from recommended preventive measures. Other diagnoses your doctor may consider include:

• Vocal cord dysfunction
• Heart failure
• Coronary heart disease
• Gastroesophageal reflux disease

_Sources:

_{O'Byrne, Paul. Patient Information. Accessed May 5, 2009. Exercise Induced Asthma}

_{Storms WW. Accessed May 22, 2009. Asthma Associated With Exercise. Immunol Allergy Clin North Am. 2005 Feb;25(1):31-43.}