In this part of the series, we will discuss the available diagnostic methods.
Asthma is diagnosed in the primary care setting using a complete medical history, family history, physical examination, and pulmonary function tests.
Your primary care doctor will determine the severity of your asthma, which in turn will affect the treatment you need.
Referral to a Respiratory Specialist in the following situations:
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Subspecialized tests are needed to confirm the diagnosis of asthma
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There is a history of a life-threatening asthma attack.
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Treatment for specific allergies
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Polypharmacy (multiple medications) is needed to control your asthma
Important points to mention during your medical consultation
Important points to mention during your medical consultation include:
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Family history of asthma and allergies.
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frequency of asthma attacks
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Timing of asthma attacks, especially if it occurs only during certain times of the year, of the day, or in certain places.
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Asthma triggers specific to you
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Conditions related to an asthma attack, such as a co-infection of the upper respiratory tract, reflux disease, stress, sleep apnea, etc.
Physical exam
The physical exam would include:
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Auscultation by your GP for wheezing in the lungs
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Examination of the upper respiratory tract, paranasal sinuses, and upper nasal passages to detect existing disease of the upper respiratory tract
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Examination for other signs of allergic conditions, for example, eczema
Diagnostic tests for asthma
Lung function tests
Pulmonary spirometry is a type of lung function test that measures the amount of air you inhale and exhale and the speed of the air.
Some specialists will use breathing medications to “treat” existing asthma and repeat lung function tests again to see if there is any improvement. This is usually done if chronic asthma is suspected. It is also done when the diagnosis of asthma is unclear.
Associated tests for asthma
Other tests performed by respiratory specialists may include:
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allergy tests
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Perform bronchial challenge tests to “trigger” a controlled asthmatic attack.
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chest x-rays
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Electrocardiograms (ECG).
asthma in young children
Many children develop asthmatic symptoms before the age of 5, and it is difficult to diagnose asthma in young children because the symptoms often occur along with many other childhood illnesses.
The reason is because children have small airways to begin with. Any respiratory condition with mucus production, for example, will further narrow your airways and cause you to hear wheezing, mimicking asthma. As the child grows, the airways enlarge and the wheezing is no longer audible.
However, asthma should be suspected if:
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One or both parents have asthma.
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Other allergic conditions, eg eczema is present
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There is a history of allergy to pollen or hay fever
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Wheezing is audible even when the child is healthy
In the following article, we will look at the challenges faced by special population groups, such as young children, pregnant women, and the elderly, etc.