Diagnosis
When asthma is suspected, the patient should describe for the doctor any pattern related to the symptoms and possible precipitating factors, including:
- Whether symptoms are more frequent during the spring or fall (allergy seasons).
- Whether exercise, a respiratory infection, or exposure to cold air has ever triggered an attack.
- Any family history of asthma or allergic disorders, such as eczema, hives, or hay fever.
- Any occupational or long-term exposure to chemicals. Early detection of occupational asthma is very important. If symptoms improve on weekends and vacation and are worse at work, the job is likely to be the source of the asthma, although this is not always the case. Asthma is common, and exacerbation at work may be coincidental.
Ruling Out Other Diseases
A number of disorders may cause some or all of the symptoms of asthma:
- Asthma and chronic obstructive lung diseases (chronic bronchitis and emphysema) affect the lungs in similar ways and, in fact, may all be present in the same person. Unlike other chronic lung conditions, asthma usually first appears in patients less than 30 years old and with chest x-rays that are normal. Still, it may be difficult to distinguish these disorders in some adults with late onset asthma.
- Panic disorder can coincide with asthma or be confused with it.
- Gastroesophageal reflux disorder (GERD) is a common companion in asthma and may affect treatment.
- Other diseases that must be considered during diagnosis are pneumonia, bronchitis, severe allergic reactions, pulmonary embolism, cancer, heart failure, tumors, psychosomatic illnesses, and certain rare disorders (such as tapeworm and trichomoniasis).
Pulmonary Function Tests
If symptoms and a patient's history suggest asthma, the doctor will usually perform tests known as pulmonary function tests to confirm the diagnosis and determine the severity of the disease.
Using a spirometer, an instrument that measures the air taken into and exhaled from the lungs, the doctor will determine several values:
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