Differential diagnosis for asthma

What Is Asthma?

Asthma is a lung illness that lasts a long time. It causes your airways to become irritated and narrowed, making breathing difficult. Asthma that is severe might make it difficult to speak or be active. It’s possible that your doctor will refer to it as a chronic respiratory condition. Asthma is also referred to as “bronchial asthma.”

Asthma is a dangerous disease that affects around 25 million people in the United States and results in nearly 1.6 million trips to the emergency room each year. You can live a happy life if you get the right treatment. You might have to go to the ER or remain in the hospital more frequently if you don’t have it, which can have an impact on your daily life.

Although asthma cannot be cured, its symptoms can be managed. Because asthma symptoms might change over time, it’s critical to keep track of your signs and symptoms with your doctor and adjust your therapy as needed.

Differential Diagnosis of Asthma

Differential Diagnosis in Adults

To treat with an asthmatic patient, the first step is to confirm that the condition is asthma. Although asthma is the cause of many occurrences of persistent cough and wheeze in children and adults, asthma is frequently misdiagnosed as other illnesses. Asthma differential diagnosis in adults involves

  • Chronic obstructive pulmonary disease (COPD),
  • Congestive heart failure,
  • Gastroesophageal reflux disease,
  • Mechanical obstruction of the airways (e.g., tumors, foreign bodies), and
  • Vocal cord dysfunction.

Infrequent causes of wheezing include

  • Pulmonary embolism,
  • Pulmonary infiltrates with eosinophilia, and
  • Some medications (e.g., angiotensin-converting enzyme (ACE) inhibitors) [NHLBI 2007].

Differential Diagnosis in Children

Chronic cough is an issue in children, and it’s important to distinguish between asthma and non-asthma. Children should be concerned if they have a chronic productive cough with purulent sputum, which is not normally a characteristic of asthma. However, a respiratory illness with purulent sputum can aggravate asthma in children who have already been diagnosed with asthma. The younger the kid, the more important it is to rule out any underlying condition as soon as possible [de Jongste and Shields 2003].

Wheezing can be an allergic (asthma) or non-allergic response in youngsters [Lemanske 2003; Weinberger 2003]. In children, non-allergic wheezing develops after acute infections, such as viral bronchiolitis. It’s tough to tell the difference between asthmatic coughing and wheezing and bronchiolitis coughing and wheezing. The differential diagnosis of children with frequent respiratory infection and wheezing should include

  • Aspiration of a foreign substance obstructing the airway
  • Pneumonia/bronchiolitis,
  • Cystic fibrosis, also known as CF, is a chronic lung disease that affects
  • Bronchopulmonary dysplasia is a condition that affects the lungs (in premature infants),
  • Primary ciliary dyskinesia syndrome, and,
  • Immune deficiency [NHLBI 2007; GINA 2011]

When should you see your doctor?

If you are experiencing any of the following dangerous symptoms, seek medical attention right away:

  • Breathing quickly
  • Face, lips, or fingernails that are pale or blue
  • When you breathe in, the skin around your ribs pulls inward.
  • Breathing, walking, and talking difficulties
  • Symptoms that do not improve despite taking medicine


Asthma symptoms differ from one person to the next. You may have rare asthma episodes, only experience symptoms at specific times of the day — such as when exercising — or experience symptoms all of the time.

The following are some of the indications and symptoms of asthma:

  • Breathing problems
  • Tightness or pain in the chest
  • Exhaling wheezing is a typical symptom of asthma in children.
  • Shortness of breath, coughing, or wheezing might make it difficult to sleep.
  • Coughing or wheezing attacks aggravated by a respiratory virus, such as the flu or a cold

The following are signs that your asthma is likely to worsen:

  • Signs and symptoms of asthma that are more common and bothersome
  • As assessed by a device that checks how well your lungs are operating, you’re having more trouble breathing (peak flow meter)
  • More frequent use of a quick-relief inhaler

Asthma symptoms and indicators flare up for some persons in the following situations:

  • Exercise-induced asthma, which can be exacerbated by cold and dry air.
  • Occupational asthma is caused by irritants in the job, such as chemical fumes, gases, or dust.
  • Allergy-induced asthma is caused by inhaling allergens such as pollen, mold spores, cockroach feces, or skin and dried saliva shed by dogs (pet dander)

Causes and Triggers of Asthma

Your airways react to objects in the environment when you have asthma. Asthma triggers are what doctors refer to them as. They have the potential to cause or exacerbate symptoms. The following are some of the most common asthma triggers:

  • Sinusitis, colds, and the flu are all examples of infections.
  • Pollens, mold, pet dander, and dust mites are examples of allergens.
  • Irritants are attracted to strong scents such as those found in perfumes or cleaning products.
  • Pollution of the air
  • Tobacco smoke is a harmful substance.
  • Exercise
  • Changes in the weather, such as temperature or humidity, or cold air
  • Gastroesophageal reflux disease (GERD) is a type of gastroesophageal reflux (GERD)
  • Food preservatives called sulfites are present in products like shrimp, pickles, beer and wine, dried fruits, and bottled lemon and lime juices.

Risk factors

A variety of factors have been linked to an increased risk of acquiring asthma. They are as follows:

  • Having an asthmatic blood relative, such as a parent or sibling
  • Having another allergic condition, such as atopic dermatitis (red, itchy skin) or hay fever (runny nose, congestion, and itchy eyes).
  • Being overweight is a problem.
  • As a smoker, you are exposed to secondhand smoke.
  • Occupational triggers, such as chemicals used in farming, hairdressing, and manufacturing, are exposed to exhaust fumes or other types of pollution.


Complications of asthma include:

  • Symptoms that make it difficult to sleep, work, or do other things
  • During asthma flare-ups, sick days from work or school are common.
  • Bronchial tube constriction is a persistent narrowing of the tubes that carry air to and from your lungs, affecting your ability to breathe.
  • Visits to the emergency room and hospitalizations due to severe asthma episodes
  • Long-term usage of several asthma treatments can have negative side effects.
  • Proper therapy makes a significant impact in preventing both short- and long-term asthma problems.

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While there is no way to prevent asthma attacks, you and your doctor can devise a step-by-step strategy for managing your illness and avoiding attacks.

  • Make sure you stick to your asthma action plan. Make a thorough strategy for taking medications and managing an asthma attack with your doctor and health care team. Then make sure you stick to your plan.

Asthma is a chronic illness that necessitates continual monitoring and treatment. You may feel more in control of your life if you take charge of your treatment.

  • Vaccinate yourself against influenza and pneumonia. Flu and pneumonia can provoke asthma flare-ups if you aren’t up to date on your vaccines.
  • Asthma triggers should be identified and avoided. Asthma episodes can be triggered by a variety of environmental allergens and irritants, ranging from pollen and mold to cold air and air pollution. Find out what triggers or aggravates your asthma and take actions to prevent them.
  • Keep an eye on your breathing. You might learn to recognize symptoms of an approaching attack, such as minor coughing, wheezing, or shortness of breath.
  • However, because your lung function may deteriorate before you experience any signs or symptoms, use a home peak flow meter to test and record your peak airflow on a regular basis. A peak flow meter is a device that monitors how strongly you can exhale. Your doctor can demonstrate how to track your peak flow at home.
  • Detect and cure attacks as soon as possible. You’re less likely to suffer a serious attack if you act promptly. You’ll also need less medicine to keep your symptoms under control.
  • Take your medication as directed when your peak flow measures drop, signaling an impending attack. Stop any action that may have caused the attack as well. If your symptoms do not improve, follow the instructions in your action plan to seek medical treatment.
  • Take your medication exactly as directed. Even if your asthma appears to be improving, don’t change your meds without first consulting your doctor. It’s a good idea to bring your meds to every doctor’s appointment. Your doctor can check to see if you’re taking your meds appropriately and at the correct dose.
  • Pay special emphasis to expanding the usage of quick-relief inhalers. Your asthma isn’t under control if you have to rely on your quick-relief inhaler, such as albuterol. Consult your doctor before making changes to your treatment.

What are the asthma treatments?

If you have asthma, you will develop a treatment plan with your health care practitioner. Ways to control your asthma symptoms and prevent asthma episodes will be part of the plan. It will include the following:

  • Techniques for avoiding triggers. If tobacco smoke is a trigger for you, for example, you should not smoke or allow others to smoke in your home or vehicle.
  • Medicines for short-term relief, commonly known as quick-relief medications. During an asthma attack, they can help prevent or reduce symptoms. They come with an inhaler that you may keep with you at all times. Other types of drugs that work swiftly to assist expand your airways may also be included.
  • Medicines that are under control. You take them on a daily basis to assist you avoid symptoms. They act by decreasing inflammation in the airways and avoiding airway constriction.

You will need emergency care if you have a severe attack and the short-term relief drugs do not work.

Your asthma treatment may be adjusted by your doctor until your symptoms are under control.

Asthma can be severe at times, and other therapies are ineffective. If you’re an adult with uncontrolled asthma, your doctor may recommend bronchial thermoplasty in some circumstances. Heat is used to reduce the smooth muscle in the lungs in this treatment. The ability of your airway to tighten is reduced by shrinking the muscle, allowing you to breathe more readily. Because the surgery carries potential dangers, it’s crucial to address these with your doctor.

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