Asthma Symptoms and Diagnosis
- Coughing: Coughing from asthma is often worse at night or early morning. Sometimes it’s your only symptom. It can be dry or mucus-filled.
- Wheezing: This is a whistling or squeaky sound especially when you breathe out. Sometimes wheezing can be heard easily; other times you need a stethoscope.
- Chest tightness: This can feel like something is squeezing or sitting on your chest.
- Shortness of breath: You may feel breathless, like you can’t catch your breath or breathe deeply enough. You may feel as though you are out of shape and constantly tired.
How Is Asthma Diagnosed?
Like a skilled detective, the doctor combines information from your family and symptom history, physical exam, and medical tests to determine whether asthma or some other cause is responsible for your symptoms.
Family and symptom history
Questions your doctor is likely to ask:
- When did you first notice symptoms?
- How would you describe them? Cough? Trouble catching your breath? Noisy breathing?
- How often do they happen?
- How long do they last?
- What makes them better or worse?
- Do you or anyone in your family have a history of eczema, allergies, asthma, food allergies, rhinitis, seasonal bronchitis, or colds that linger for months instead of days?
- Does anyone in your family, home or workplace smoke?
- Do you cough or have problems catching your breath when exercising?
- Do breathing problems disturb your sleep?
- What is your home, school, and work environment like? Do you have pets? Carpets or wood floors? Water damage in your basement?
Next, the doctor will do a physical exam, looking inside your nose and watching the way your chest and stomach muscles move when you breathe. The doctor will use a stethoscope to listen to air flowing in and out of your lungs.
The doctor will be looking for signs of conditions that often go along with asthma such as rhinitis (inflammation of the nose), sinusitis (inflammation of the sinuses), nasal polyps (mucus-filled sacks in the nose), eczema or dermatitis (skin irritation).
If the signs begin to point to asthma, the doctor may use a computerized machine called a spirometer to check how well your lungs are working. You’ll be asked to take a deep breath in and then breathe out as hard as you can into the machine. The spirometer shows the amount of air you are able to breathe in and out and how fast you did it over a certain time period. If your airways are inflamed and narrowed, or if the muscles around your airways tighten up, the results will show it.
You may do this test several times, perhaps before and after using a quick-relief bronchodilator (albuterol) to relax the airways. Test results that improve after using the medicine are a strong indication of asthma.
If you are having no symptoms on the day of your exam, the results of your lung function testing may be normal. In this case, your doctor may order another test called a methacholine challenge. This medication causes a brief tightening of the airways that is more intense in people who have asthma.
Other tests might include:
- Allergy tests, either skin or blood
- A test to see how your airways react to exercise
- Tests for other conditions, such as gastroesophageal reflux disease (GERD) or obstructive sleep apnea
- A test for sinus disease
- A chest x-ray or electrocardiogram to check for foreign objects in the airways or signs of separate lung or heart disease
- A fractional exhaled nitric oxide (FeNO) test to measure lung inflammation
After the Diagnosis: Asthma treatment and medications
For more on Asthma Symptoms and Diagnosis:
- Ask the Allergist: When Asthma Turns Severe
- Asthma Dictionary
- When to See an Asthma Specialist
- Mild, moderate or severe asthma?
- Exhaled Nitric Oxide Testing – FeNO
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