Asthma Recognition

Look for these symptoms in athletes when asthma is suspected:

Initial Diagnosis

Recognition of signs and symptoms commonly lead the athlete to seek medical advice.

Note: diagnoses made using a bronchodilator should only be performed by a physician.

Signs and symptoms may include:

  • Episodic breathlessness
  • Wheezing
  • Coughing
  • Chest tightness
  • Difficulty speaking in complete sentences
  • Shortness of breath
  • Drowsiness
  • Confusion
  • Use of accessory muscles for breathing
  • Measure Lung Function (Spirometry)

Forced Expiratory Volume (FEV)

  • Measurement of the amount of airflow in the first second of expiration
  • Diagnosis of asthma at < 40% FEV
Severity of Obstruction % of FEV
Mild 70-99%
Moderate 50-69%
Severe 35-49%
Very Severe < 35%
  • If a bronchodilator increases FEV by 12%, asthma may be diagnosed.

Peak Expiratory Flow Rate (PEFR)

  • May be used to diagnose (but not preferred) and monitor management of asthma
  • Peak Flow Meters are commonly inexpensive, portable, and easy to use
  • Because of large range of scores, PEF score can only be compared to the patient’s own best score
  • Diagnosis of asthma at 20% improvement after bronchodilator use

These methods may also be used in conjunction with common allergens or triggers to determine individual sensitivities for prevention of asthmatic episodes.

 

Episodic Diagnosis

Diagnosis of an asthma episode or “attack” is primarily based on signs and symptoms.  Signs and symptoms may include:

  • Episodic breathlessness
  • Wheezing
  • Coughing
  • Chest tightness
  • Difficulty speaking in complete sentences
  • Shortness of breath
  • Drowsiness
  • Confusion
  • Use of accessory muscles for breathing

As an athlete is restricted of oxygen from breathing difficulty, the possibility of loss of consciousness or other mental status changes becomes more imminent.

 

What else could this be?

  • Upper airway obstruction
  • Inhaled foreign body (choking)
  • Exercise-induced bronchospasm
  • Anaphylaxis
  • Vocal cord dysfunction
  • Anxiety/Panic attacks causing hyperventilation
  • Spontaneous Pneumothorax
  • Other forms of obstructive lung disease (primarily COPD)
  • Symptoms may also have non-respiratory causes (left ventricular failure)

 

Follow this algorithm to determine diagnosis and treatment options:

Asthma Algorithm