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Master asthma diagnosis and management concepts

Content based on NHLBI Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma (EPR-3)

Asthma diagnosis is based on clinical presentation and objective measures of reversible airway obstruction.

Key Diagnostic Features:

  • Recurrent symptoms of airway obstruction: wheezing, coughing, chest tightness, shortness of breath
  • Symptoms often worse at night or early morning
  • Symptoms triggered by: exercise, allergens, irritants, weather changes, viral infections
  • Family history of asthma or atopy increases likelihood
  • Physical exam may show wheezing, prolonged expiration during exacerbation

Role of Spirometry (for patients ≥5 years)

  • FEV1/FVC ratio <0.80 suggests obstruction
  • Improvement in FEV1 ≥12% AND ≥200mL after bronchodilator confirms reversibility
  • Normal spirometry does not rule out asthma
  • Consider methacholine challenge if spirometry normal but asthma suspected