Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • cough
  • wheezing
  • shortness of breath
  • inability to speak
  • chest tightness
  • sleep disturbance
  • accessory muscle use
  • tachypnoea
  • tachycardia
  • wheezing, poor air movement, or diminished breath sounds

Other diagnostic factors

  • exercise limitation
  • stridor
  • cyanosis

Risk factors

  • viral infection
  • respiratory bacterial infection
  • current smoker or exposure to second-hand cigarette smoke
  • exposure to allergens (including history of seasonal allergic rhinitis)
  • atopic eczema
  • environmental irritants
  • poor indoor air quality
  • gastro-oesophageal reflux disease
  • history of asthma
  • history of hospitalisation for asthma exacerbations
  • use of oral corticosteroids
  • non-compliance to asthma medication

Diagnostic investigations

1st investigations to order

  • peak flow measurement (peak expiratory flow or FEV1)
  • oxygen saturation
  • short-acting bronchodilator trial
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Professor of Medicine

Stanford University School of Medicine

Chief

Pulmonary Section

US Department of Veterans Affairs

Palo Alto Health Care System

Palo Alto

CA

Disclosures

WK declares that he has no competing interests.

Dr Ware Kuschner would like to gratefully acknowledge Dr Michael Ezzie and Dr Jonathan P. Parsons, the previous contributors to this monograph. ME declares that he has no competing interests. JPP is a member of Speakers Bureaus for GlaxoSmithKline, Inc.; Schering-Plough, Inc.; and AstraZeneca, Inc.

Peer reviewers VIEW ALL

Assistant Professor

Pulmonary and Critical Care Medicine

University of Vermont

Burlington

VT

Disclosures

AD declares that she has no competing interests.

Professor of Respiratory Medicine

Institute of Infection, Immunity & Inflammation

University of Glasgow

Glasgow

Scotland

UK

Disclosures

NCT declares that he has no competing interests.

Consultant Chest Physician

Chest Clinic C

Aberdeen Royal Infirmary

Aberdeen

Scotland

UK

Disclosures

GPC declares that he has no competing interests.

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