Atak astmy
Diagnostyka i diagnoza

Atak astmy charakteryzuje się nagłym nasileniem objawów takich jak duszność, świszczący oddech, uczucie ucisku w klatce piersiowej oraz kaszel. Diagnostyka opiera się na ocenie klinicznej, badaniu fizykalnym oraz testach funkcji płuc, w tym spirometrii (kluczowy parametr FEV1), pomiarze szczytowego przepływu wydechowego (PEF), pulsoksymetrii oraz gazometrii krwi tętniczej. Wartości FEV1 i PEF w stosunku do wartości należnych pozwalają ocenić ciężkość ataku, która klasyfikowana jest jako łagodna, umiarkowana, ciężka lub zagrażająca życiu. Badania obrazowe, takie jak RTG klatki piersiowej, są wskazane w ciężkich lub atypowych przypadkach w celu wykluczenia innych przyczyn objawów, a HRCT może wykazać zmiany morfologiczne charakterystyczne dla astmy, takie jak pogrubienie ścian oskrzeli czy pułapka powietrzna. Dodatkowo, pomiar frakcji wydychanego tlenku azotu (FeNO >40-50 ppb) oraz badania krwi (eozynofile, IgE, cAMP) dostarczają informacji o stanie zapalnym i nasileniu choroby.

Diagnostyka ataku astmy

Atak astmy to stan, w którym dochodzi do nagłego nasilenia objawów choroby, objawiający się trudnościami w oddychaniu, uczuciem ucisku w klatce piersiowej, świszczącym oddechem oraz kaszlem. Prawidłowa i szybka diagnoza ataku astmy jest kluczowa dla wdrożenia odpowiedniego leczenia i zapobieżenia potencjalnie zagrażającym życiu powikłaniom.12

Ocena kliniczna w czasie ataku

Diagnoza ataku astmy opiera się przede wszystkim na szczegółowej ocenie klinicznej. Jeśli objawy nie ustępują po zastosowaniu domowego leczenia, konieczna jest wizyta u lekarza lub w oddziale ratunkowym. W czasie wizyty w placówce medycznej pacjent otrzymuje leczenie i równocześnie przeprowadzane są testy diagnostyczne. Główne cele to poprawa oddychania, ocena ciężkości ataku astmy oraz sprawdzenie skuteczności stosowanego leczenia.12

Podczas wizyty lekarz przeprowadza badanie fizykalne, oceniając ruchy klatki piersiowej i brzucha podczas oddychania oraz używając stetoskopu do osłuchania przepływu powietrza przez płuca. Badanie to może wykazać świszczący oddech, który jest najbardziej specyficznym objawem astmy, choć w przypadku ciężkiego ataku astmy może występować słabe wejście powietrza do płuc i brak świstów (tzw. „cicha klatka piersiowa”).12

Testy diagnostyczne podczas ataku

Podczas ataku astmy przeprowadza się szereg testów diagnostycznych, które pomagają ocenić ciężkość stanu pacjenta oraz monitorować odpowiedź na leczenie:12

Ocena ciężkości ataku

Ocena ciężkości ataku astmy jest kluczowym elementem diagnostyki, który determinuje intensywność i rodzaj wdrażanego leczenia. Lekarze oceniają ciężkość na podstawie objawów klinicznych oraz wyników badań czynności płuc.12

Parametry brane pod uwagę podczas oceny ciężkości ataku astmy to:12

  • Częstość oddechów
  • Użycie dodatkowych mięśni oddechowych
  • Wysycenie krwi tlenem (saturacja)
  • Wartość PEF lub FEV1 w stosunku do wartości należnej lub najlepszej osobistej
  • Zdolność do mówienia pełnymi zdaniami
  • Stan świadomości
  • Obecność i nasilenie świstów

Na podstawie tych parametrów ataki astmy klasyfikuje się jako łagodne, umiarkowane, ciężkie lub zagrażające życiu (stan astmatyczny).12

Różnicowanie i wykluczenie innych stanów

Podczas diagnostyki ataku astmy ważne jest różnicowanie z innymi stanami, które mogą powodować podobne objawy. W tym celu lekarze mogą przeprowadzać dodatkowe badania, takie jak RTG klatki piersiowej czy badania krwi, aby wykluczyć inne potencjalne przyczyny.12

Stany, które mogą naśladować atak astmy i wymagają różnicowania, to między innymi:123

  • Dysfunkcja strun głosowych – charakteryzująca się paradoksalnym zwężeniem strun głosowych podczas wdechu
  • Aspiracja ciała obcego – mogąca powodować zarówno lokalne, jak i uogólnione świsty
  • Niewydolność serca – objawiająca się „astmą sercową” z dusznością i świstami
  • Zapalenie płuc – mogące powodować duszność i kaszel
  • Zatorowość płucna – charakteryzująca się nagłą dusznością i bólem w klatce piersiowej
  • Choroby górnych dróg oddechowych – w tym zapalenie zatok, które często współwystępuje z astmą
  • Refluks żołądkowo-przełykowy (GERD) – mogący powodować lub zaostrzać objawy astmy

Diagnostyka obrazowa w ataku astmy

Badania obrazowe nie są rutynowo stosowane w diagnostyce ataku astmy, jednak w niektórych przypadkach mogą być pomocne w wykluczeniu innych przyczyn objawów lub identyfikacji powikłań.1

RTG klatki piersiowej

RTG klatki piersiowej jest podstawowym badaniem obrazowym wykonywanym u pacjentów z atakiem astmy, szczególnie w przypadkach ciężkich lub atypowych. Wartość tego badania polega na ujawnieniu powikłań lub alternatywnych przyczyn świstów podczas diagnozowania astmy i jej zaostrzeń.12

W badaniu fińskim dotyczącym przyjęć do szpitala z powodu ostrego ataku astmy, RTG klatki piersiowej wykonane przy przyjęciu wykazało nieprawidłowości u 50% pacjentów i spowodowało zmiany w leczeniu u 5% badanych.1

Tomografia komputerowa wysokiej rozdzielczości (HRCT)

Tomografia komputerowa wysokiej rozdzielczości (HRCT) jest bardziej kosztowna niż RTG klatki piersiowej i naraża pacjenta na większą dawkę promieniowania. Niemniej jednak, badania CT mogą wykazać szereg zmian, które potwierdzają diagnozę astmy.12

HRCT pozostaje najbardziej czułym badaniem dla zmian morfologicznych związanych z astmą, takich jak pogrubienie ścian dróg oddechowych czy pułapka powietrzna. Korelację uwięzienia powietrza z funkcją płuc badano za pomocą HRCT u 74 pacjentów z przewlekłą chorobą dróg oddechowych, w tym z astmą, i stwierdzono, że na skanach HRCT wykonywanych podczas wydechu, wyniki pułapki powietrznej były odwrotnie skorelowane z FEV1, FEV1/FVC i FEF25.1

Diagnostyka laboratoryjna

Badania laboratoryjne mogą dostarczyć dodatkowych informacji pomocnych w diagnostyce ataku astmy oraz w określeniu jego typu i ciężkości.1

Frakcja wydychanego tlenku azotu (FeNO)

Testy frakcji wydychanego tlenku azotu (FeNO) mierzą ilość tlenku azotu w wydychanym powietrzu. Wysokie poziomy tlenku azotu mogą wskazywać na stan zapalny dróg oddechowych, co może utrudniać oddychanie. Zapalenie eozynofilowe dróg oddechowych powoduje zwiększoną regulację syntazy tlenku azotu w błonie śluzowej układu oddechowego, prowadząc do podwyższonego poziomu tlenku azotu w wydychanym powietrzu. U niektórych pacjentów z astmą stężenie FeNO przekracza poziomy obserwowane u osób bez astmy. Pomiar FeNO przekraczający 40-50 ppb może pomóc w potwierdzeniu diagnozy astmy.12

Badania krwi

Badania krwi mogą mierzyć poziomy białych krwinek, co może wskazywać na stan zapalny. Wysokie poziomy eozynofilów (rodzaj białych krwinek) i immunoglobuliny E (IgE, rodzaj przeciwciała) we krwi mogą wskazywać na astmę.12

Nowsze badania wskazują na potencjał prostych testów krwi w diagnozowaniu astmy. Naukowcy z Rutgers Health odkryli, że prosty test krwi może diagnozować astmę i określać jej nasilenie. Zespół badawczy przeanalizował próbki krwi od 87 pacjentów z astmą i 273 uczestników bez astmy. Stwierdzili, że poziomy cAMP były konsekwentnie wyższe we krwi pacjentów z astmą i korelowały z ciężkością choroby, potencjalnie oferując lekarzom nowe narzędzie do monitorowania stanu pacjenta.1

Postępowanie diagnostyczne u dzieci

Diagnozowanie ataku astmy u dzieci, szczególnie poniżej 5. roku życia, stanowi szczególne wyzwanie, ponieważ maluchy mają trudności z wykonaniem standardowych testów spirometrycznych, a wiele innych chorób może powodować kaszel i świszczący oddech u małych dzieci.12

Testy czynnościowe płuc u dzieci poniżej 5. roku życia zazwyczaj nie są wykonywane. Jeśli lekarz podejrzewa astmę u dziecka, może przepisać lek rozszerzający oskrzela – substancję, która otwiera drogi oddechowe. U dzieci poniżej 5. roku życia astma jest diagnozowana głównie na podstawie objawów, wywiadu rodzinnego i zdrowotnego oraz badania fizykalnego.12

Lekarz oceni objawy dziecka i wyjaśnienie tych objawów przez rodzica, a następnie może podać dziecku lek przeciwastmatyczny, aby zmierzyć jego efekt – jest to tzw. próba leczenia. U dzieci w wieku 5 lat i starszych, test czynnościowy płuc (spirometria) może pomóc w diagnozie astmy.12

Leczenie w oparciu o diagnostykę

Na podstawie wyników diagnostyki lekarz określa odpowiednie leczenie ataku astmy. Leczenie zależy od ciężkości ataku i odpowiedzi pacjenta na wstępne leczenie.1

Jeśli udasz się na oddział ratunkowy z powodu ataku astmy, najprawdopodobniej otrzymasz szereg zabiegów mających na celu przywrócenie normalnego oddychania:12

  • Leki rozszerzające oskrzela – szybko działające leki, które rozluźniają mięśnie wokół dróg oddechowych
  • Tlen – podawany przez maskę, jeśli poziom tlenu we krwi jest niski
  • Nebulizator – urządzenie do wdychania wysokich dawek leków
  • Kortykosteroidy – w formie tabletek lub zastrzyków, aby zmniejszyć stan zapalny

Lekarz może polecić przyjmowanie dodatkowych dawek lub zmianę dawek leku. Po wizycie na oddziale ratunkowym z powodu ataku astmy, otrzymasz instrukcje dotyczące dalszego postępowania i informacje, kiedy należy wezwać lekarza lub udać się do szpitala.12

Monitorowanie po ataku

Po ataku astmy kluczowe jest regularne monitorowanie stanu pacjenta oraz wdrożenie odpowiedniego planu działania w celu zapobiegania przyszłym atakom.1

Kontrola po ataku astmy jest niezbędna do optymalizacji terapii podtrzymującej i zapobiegania przyszłym atakom. Obecne standardy jakości NICE (Wielka Brytania) stanowią, że wszystkie osoby hospitalizowane z powodu ataku astmy powinny odbyć wizytę kontrolną w podstawowej opiece zdrowotnej w ciągu dwóch dni roboczych od wypisu, aby przejrzeć leczenie podtrzymujące i zapewnić ustąpienie objawów.1

Lekarz będzie współpracował z pacjentem w celu opracowania planu działania w przypadku astmy. Plan ten określa, jak zarządzać objawami na co dzień i co robić podczas ataku astmy. Zazwyczaj zawiera instrukcje, kiedy używać inhalatora, jak monitorować objawy i kiedy szukać pomocy w nagłych wypadkach.12

Wczesna diagnoza i jej znaczenie

Wczesna i precyzyjna diagnoza ataku astmy ma kluczowe znaczenie dla skutecznego leczenia i zapobiegania powikłaniom. Atak astmy może być stanem zagrażającym życiu, ale odpowiednie leczenie astmy zmniejsza to ryzyko.12

Większość zgonów związanych z astmą można zapobiec, jeśli czynniki ryzyka zostaną wcześnie zidentyfikowane i rozwiązane. Główne czynniki ryzyka, które stawiają pacjentów w grupie wysokiego ryzyka przyszłych śmiertelnych zaostrzeń astmy, obejmują niedawną historię słabo kontrolowanej astmy.1

Wczesna diagnoza i skuteczne leczenie mogą znacznie poprawić jakość życia i zapobiec atakom astmy. Dlatego tak ważne jest, aby osoby z objawami astmy skonsultowały się z lekarzem w celu prawidłowej diagnostyki i monitorowania.12

Kolejne rozdziały

Zapraszamy do dalszego czytania naszego leksykonu.

Wybierz kolejny rozdział z menu poniżej, aby otworzyć nową podstronę kompedium wiedzy i uzyskać szczegółowe informację o leku, substancji lub chorobie.

  1. 12.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Asthma attack – Diagnosis and treatment – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/asthma-attack/diagnosis-treatment/drc-20354274
    If your symptoms don’t improve with at-home treatment, you will need to see your healthcare professional or get emergency care. […] If you go to your clinic or the emergency room for treatment, you will likely get treatments and have tests at the same time. The goal is to improve your breathing, to judge how severe an asthma attack is and to see whether the treatment is working. […] Tests to measure how well your lungs are working may include: […] A spirometer measures how much air your lungs can hold and how quickly you can breathe out. This measurement is called forced expiratory volume (FEV-1). Your FEV-1 measurement is compared with the typical FEV-1 for people who don’t have asthma. […] Your healthcare professional may tell you whether to take additional doses or change doses of a medicine. […] If you go to the emergency room for an asthma attack in progress, you’ll likely get a number of treatments to restore regular breathing. […] You’ll be given instructions for: […] Do you know when to call me or go to the hospital?
  • #1 Asthma Diagnosis and Testing – Allergy & Asthma Network
    https://allergyasthmanetwork.org/what-is-asthma/how-is-asthma-diagnosed/
    Diagnosing asthma is often difficult. For many, asthma symptoms tend to come and go. Thats why its important to talk with a doctor, preferably an asthma specialist, about your symptoms. Asthma specialists are board-certified allergists and pulmonologists who are familiar with asthma diagnosis and treatment guidelines. […] There is no single factor or test that confirms an asthma diagnosis. Rather it is like putting together a puzzle to see if everything fits. […] Your doctor may ask questions about your asthma symptoms, your medical history, and your family history. […] Doctors will watch the way your chest and stomach muscles move when you breathe. They will use a stethoscope to listen to air flowing in and out of your lungs. […] If asthma is suspected to be the cause, then diagnostic tests are needed. Part of diagnosing asthma includes breathing tests or lung function tests (also called pulmonary function tests). These tests measure lung function.
  • #1 Tests During An Asthma Attack: Evaluating SeverityShare to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon
    https://asthma.net/diagnosis/tests-during-an-attack
    During an asthma attack, symptoms worsen quickly. […] Tests can help doctors diagnose, assess, and treat an asthma attack. Common tests for asthma – such as bloodwork, peak flow, chest X-ray, and spirometry – assess lung function. […] Doctors will perform tests during an asthma attack in a doctor’s office or emergency room. They may do this to: Confirm a diagnosis of an asthma attack, Understand the severity of the asthma attack, Check if you are in or near respiratory failure, See how well quick-relief treatments are working, Rule out other conditions or complications. […] You may also perform tests when an asthma attack starts at home. The results may help you respond to signs of an asthma attack. […] While starting treatment, doctors will assess your symptoms. This can help determine the severity of the asthma attack.
  • #1 Asthma – Diagnosis | NHLBI, NIH
    https://www.nhlbi.nih.gov/health/asthma/diagnosis
    Talk to your healthcare provider if you or your child have asthma symptoms. […] Your healthcare provider may want to run some tests to diagnose your asthma. […] Lung function tests measure how well you can breathe in and out: […] Spirometry measures how much air you breathe out and how fast. […] Peak expiratory flow (PEF) tests measure how fast you can blow air out using maximum effort. […] Bronchodilator responsiveness tests measure how much better you can blow air after inhaling a fast-acting bronchodilator, a medicine that helps open your airways by relaxing the muscles around them. […] Challenge tests, also called bronchial provocation tests, assess how sensitive your airways are. […] Your healthcare provider may want to run other tests to help diagnose your asthma. […] Allergy tests can find which allergens, such as pet dander or pollen, cause a reaction in your body when you are around them.
  • #1 Tests During An Asthma Attack: Evaluating SeverityShare to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon
    https://asthma.net/diagnosis/tests-during-an-attack
    Doctors will monitor you for signs of other conditions. For example, fever or hives may indicate pneumonia or another diagnosis. These signs can help doctors make the correct diagnosis during an asthma attack. […] Test results are more reliable to diagnose and assess asthma attacks. Doctors will perform these tests while starting treatment. Some common tests during an asthma attack include: Peak flow measures how fast you can breathe out. […] Spirometry measures how much air you can breathe out. […] Pulse oximetry measures the amount of oxygen in your blood (called „oxygen saturation”). […] Blood tests can measure the amount of oxygen and carbon dioxide in your blood. Increased levels of carbon dioxide may indicate respiratory failure. […] Chest X-rays are commonly used to make sure you do not have another condition, such as a collapsed lung or pneumonia.
  • #1 Asthma – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK430901/
    Patients showing airflow limitations on spirometry receive 2 to 4 puffs of a short-acting bronchodilator like albuterol, followed by repeat spirometry in 10 to 15 minutes. […] During bronchoprovocation testing, clinicians induce bronchoconstriction using inhaled methacholine or mannitol, exercise, or eucapnic hyperventilation of dry air. […] Eosinophilic airway inflammation causes an upregulation of nitric oxide synthase in the respiratory mucosa, leading to elevated nitric oxide levels in exhaled breath. In certain asthma patients, the fractional exhaled nitric oxide (FENO) surpasses levels observed in individuals without asthma. A FENO of measurement exceeding 40 to 50 ppb can aid in confirming an asthma diagnosis. […] Each patient should undergo a rapid assessment of their vital signs, including oxygen saturation. Measuring the peak flow can indicate the severity of the exacerbation and monitor the response to therapy. […] Most asthma-related deaths are preventable if risk factors are identified and addressed early. Major risk factors that place patients at high risk for future fatal asthma exacerbations include a recent history of poorly controlled asthma.
  • #1 Asthma – Wikipedia
    https://en.wikipedia.org/wiki/Asthma
    Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. […] An acute asthma exacerbation is commonly referred to as an asthma attack. […] Acute severe asthma, previously known as status asthmaticus, is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators and corticosteroids.
  • #1 Asthma Differential Diagnoses
    https://emedicine.medscape.com/article/296301-differential
    Vocal cord dysfunction may exist alone or with asthma, it is caused by paradoxical adduction of the vocal cords during inspiration, and may disappear with panting, speech, or laughing. […] Patients with chronic symptoms suggestive of asthma, normal spirometry, poor response to asthma medications, and frequent evaluations should be evaluated for vocal cord dysfunction. […] Usually, the diagnosis can be made using direct laryngoscopy, but only during symptomatic periods or after exercise. […] The presence of flattening of the inspiratory limb of the flow-volume loop may also suggest vocal cord dysfunction, but this is only seen in 28% of patients at baseline. […] A variety of airway tumors are reported to manifest with symptoms similar to those of asthma. […] Other tracheal lesions can include bronchocentric granulomatosis, subglottic stenosis, subglottic web, tracheal hamartoma, bronchogenic cysts, leiomyoma, and tracheobronchopathia osteoplastica.
  • #1 Asthma Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography
    https://emedicine.medscape.com/article/353436-overview
    Chest radiographic imaging is an important tool in the examination of patients with an exacerbation of asthma, but patients should not be left waiting in the treatment room for a radiograph before treatment. […] Chest radiography is the initial imaging evaluation in most individuals with symptoms of asthma. The value of chest radiography is in revealing complications or alternative causes of wheezing in the diagnosis of asthma and its exacerbations. […] Significant advancements have been made in a number of imaging techniques used for evaluating patients with asthma. […] HRCT is more costly than chest radiography and exposes the patient to more radiation. Nevertheless, CT scans can demonstrate a number of findings that support the diagnosis of asthma. […] HRCT remains the most sensitive study for morphologic changes associated with asthma.
  • #1 Asthma Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography
    https://emedicine.medscape.com/article/353436-overview
    The aphorism attributed to Chevallier Jackson states, „All that wheezes is not asthma.” This recognition suggests that imaging has an important role in differentiating asthma from its mimics and that further diagnostic evaluation and treatment of nonasthma conditions may be necessary. […] When asthma does not respond to maintenance treatment, other possible diagnoses, such as cystic fibrosis, primary ciliary dyskinesia, immunodeficiency conditions, or airway and vascular malformations, must be excluded. […] In a Finnish study of hospital admissions for acute asthma, admission chest radiographs showed abnormalities in 50% of the patients and resulted in treatment changes in 5%. […] In a British general hospital ED, findings in 695 episodes of acute asthma in adults and children were evaluated. Chest radiographs were obtained in 135 of 695 patients, or 19% of the total instances of asthmatic exacerbation.
  • #1 Asthma Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography
    https://emedicine.medscape.com/article/353436-overview
    The direct measurement of airway wall thickness with chest radiographs was undertaken in patients with mild and severe asthma and in individuals without asthma. […] The reliability of planimetry in the diagnosis of asthma in children also was established, but other findings cast doubt on the usefulness of planimetry in patients with occupational asthma. […] The correlation of airtrapping with pulmonary function was studied by using HRCT in 74 patients with chronic airway disease, including asthma, and it was found that on expiratory HRCT scans, the airtrapping and expired volume scores were inversely correlated with FEV1, FEV1/FVC, and FEF25. […] Paganin et al found both reversible and irreversible findings on HRCT scans of individuals with asthma.
  • #1 Asthma – Diagnosis | NHLBI, NIH
    https://www.nhlbi.nih.gov/health/asthma/diagnosis
    Fractional exhaled nitric oxide (FeNO) tests measure how much nitric oxide is in your breath. […] High levels of nitric oxide may mean that your airways are inflamed, which can make it hard to breathe. […] Blood tests can measure levels of white blood cells, which can indicate inflammation. […] A chest CT scan may show whether the walls of your airways are thicker. […] Most diagnostic tests for asthma do not work well for young children. This can make it difficult to diagnose asthma in children.
  • #1 Scientists Discover Potential Blood Test for Asthma Diagnosis and Severity | Rutgers University
    https://www.rutgers.edu/news/scientists-discover-potential-blood-test-asthma-diagnosis-and-severity
    Scientists at Rutgers Health have discovered that a simple blood test could diagnose asthma and determine its severity, a breakthrough that could transform how the disease is identified and monitored. […] The research team analyzed blood samples from 87 asthma patients and 273 participants without asthma. They found that cAMP levels were consistently higher in the blood of asthma patients and correlated with disease severity, potentially offering doctors a new tool for monitoring patient conditions. […] The development of this blood test could help doctors better identify which patients need more aggressive treatment and monitor their response to therapy more accurately.
  • #1 Diagnosing asthma | Better Health Channel
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diagnosing-asthma
    Doctors do not use one specific test to diagnose asthma. […] To help diagnose asthma, your doctor will take your medical history, do a physical examination, listen to your lungs and order some lung function tests. […] A lung function test measures airflow in and out of the lungs, and will help your doctor to diagnose asthma. […] In people older than 5 years, a lung function test that measures airflow in and out of the lungs will help your doctor to diagnose asthma. […] Asthma is more likely to be diagnosed if your symptoms: keep coming back, or happen at the same time each year; are worse at night or in the early morning; are clearly triggered by exercise, allergies or infections, or have a seasonal pattern; improve quickly with reliever medication. […] Its often difficult to diagnose asthma in children under 5, particularly as they find breathing tests difficult and there are many other causes for coughing and wheezing in small children. […] Your doctor will assess your childs symptoms and your explanation of their symptoms, and may give your child asthma medicine to measure its effect this is called a treatment trial. […] A lung function test (spirometry) can help to diagnose asthma in adults and children 5 years and older.
  • #1 Asthma: Steps in testing and diagnosis
    https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma/art-20045198
    If your spirometer results are typical or near typical, your healthcare professional might try to trigger asthma symptoms. […] If you appear to have asthma triggered by exercise, called exercise-induced asthma, you may be asked to do physical activity to see whether it triggers symptoms. […] Lung tests in children under age 5 are not typically done. […] If your child’s healthcare professional suspects asthma, your child may be prescribed a bronchodilator a drug that opens the airways. […] You breathe into a tube connected to a machine that measures the amount of nitric oxide gas in your breath. […] Your healthcare professional also may perform allergy tests. […] Even if a diagnosis isn’t certain, your care professional may prescribe medicines or other treatment to see what helps.
  • #1 Diagnosis and management of asthma in children | BMJ Paediatrics Open
    https://bmjpaedsopen.bmj.com/content/6/1/e001277
    The diagnosis of asthma should therefore be reviewed routinely to identify true asthma and alter treatment where necessary. […] The following features have been shown to increase the likelihood of future severe attacks, and particular attention should be given to these factors during asthma reviews: Previous attack. The strongest risk factor for a future asthma attack is a personal history of a previous attack. […] It is essential that a postattack review is conducted to review asthma maintenance treatment, as this is likely to be suboptimal. […] Current NICE quality standards (UK) state that all individuals hospitalised with an asthma attack should receive a follow-up review in primary care within two working days of discharge, to review maintenance management and ensure resolution of symptoms.
  • #1 Asthma: Types, Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/6424-asthma
    If you have asthma, you can still live a very productive life and participate in sports and other activities. Your healthcare provider can help you manage symptoms, learn your triggers and prevent or manage attacks. […] Your healthcare provider will work with you to develop an asthma action plan. This plan tells you how and when to use your medicines. It also tells you what to do based on your asthma symptoms and when to seek emergency care. […] If you have a severe asthma attack, you need to get immediate medical care. […] You should use the rescue inhaler when symptoms are bothering you and you can use it more frequently if your flare is severe.
  • #1 Asthma
    https://www.nhs.uk/conditions/asthma/
    An asthma attack is when you have severe symptoms and it’s difficult to breathe, which can be life-threatening. […] If you or your child have symptoms of asthma a GP or nurse will ask you some questions and listen to your chest. […] You may need a simple breathing test to check for signs of asthma, and sometimes a blood test. […] Asthma can take some time to diagnose because the symptoms often vary over time and breathing problems can have different causes. If it’s likely you have asthma, you may be offered asthma medicines to see if they help your symptoms. […] If you have a severe asthma attack that does not get better, you may need to be treated in hospital. Hospital treatments may include: oxygen through a mask, using a nebuliser to breathe in high doses of medicine, steroid tablets or injections. […] An asthma attack can be life-threatening. But getting the right asthma treatment reduces the risk.
  • #1 Understanding the Diagnosis and Treatment of Asthma
    https://www.lanermc.org/community/lane-health-blog/understanding-the-diagnosis-and-treatment-of-asthma
    Diagnosing asthma is not always straightforward because the symptoms can be similar to other respiratory conditions. […] To confirm an asthma diagnosis, doctors often use lung function tests. The most common test is spirometry, which measures how much air you can exhale and how fast you can blow air out. This test helps assess airway obstruction and the severity of your asthma. […] Your doctor will work with you to develop a personalized asthma action plan, which outlines how to manage your symptoms on a daily basis and what to do during an asthma attack. It typically includes instructions on when to use your inhaler, how to monitor symptoms, and when to seek emergency care. […] Early diagnosis and effective treatment can significantly improve your quality of life and prevent asthma attacks.
  • #2 Asthma
    https://www.nhs.uk/conditions/asthma/
    An asthma attack is when you have severe symptoms and it’s difficult to breathe, which can be life-threatening. […] If you or your child have symptoms of asthma a GP or nurse will ask you some questions and listen to your chest. […] You may need a simple breathing test to check for signs of asthma, and sometimes a blood test. […] Asthma can take some time to diagnose because the symptoms often vary over time and breathing problems can have different causes. If it’s likely you have asthma, you may be offered asthma medicines to see if they help your symptoms. […] If you have a severe asthma attack that does not get better, you may need to be treated in hospital. Hospital treatments may include: oxygen through a mask, using a nebuliser to breathe in high doses of medicine, steroid tablets or injections. […] An asthma attack can be life-threatening. But getting the right asthma treatment reduces the risk.
  • #2 Asthma: Steps in testing and diagnosis
    https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma/art-20045198
    Diagnosing asthma generally includes a medical history, physical exam and lung tests. […] An asthma diagnosis is based on several factors, including a detailed medical history, a physical exam, your symptoms, and overall health and test results. […] The first step in diagnosing asthma is talking to your healthcare team about your symptoms and your health. […] Your healthcare professional may use several tests to check how well your lungs are working. […] This is the main test doctors generally use to diagnose asthma in people 5 years or older. […] If certain measurements are below usual for a person your age, it may mean that asthma has narrowed your airways. […] After taking lung test measurements, you may be asked to inhale an asthma drug to open air passages and then do the test again.
  • #2 Asthma in adults – Symptoms, diagnosis and treatment | BMJ Best Practice US
    https://bestpractice.bmj.com/topics/en-us/44
    Asthma in adults presents with recurrent episodes of shortness of breath, chest tightness, wheezing, or coughing. […] Examination typically demonstrates an expiratory wheeze; however, in severe asthma there is poor air entry and the chest is silent. […] Treatment is stepwise, based on symptoms. Patients may need to monitor their peak expiratory flow daily and should be aware of the warning signs of a severe attack. […] Asthma is a chronic inflammatory airway disease characterized by intermittent airway obstruction and hyper-reactivity. […] Key diagnostic factors include recent upper respiratory tract infection, dyspnea, cough, expiratory wheezes, and nasal polyposis. […] 1st tests to order include FEV/FVC ratio and peak expiratory flow (PEF). […] Tests to consider include chest x-ray, CBC, fractional exhaled nitric oxide (FeNO), bronchial challenge test, immunoassay for allergen-specific IgE, skin prick allergy testing, high-resolution CT (HRCT) chest, and CT sinus. […] Emerging tests include sputum eosinophil count.
  • #2 Tests During An Asthma Attack: Evaluating SeverityShare to Facebookprint pageBookmark for latercaret iconFollow us on facebookFollow us on instagramFollow us on facebookFollow us on linkedincaret icon
    https://asthma.net/diagnosis/tests-during-an-attack
    Doctors will monitor you for signs of other conditions. For example, fever or hives may indicate pneumonia or another diagnosis. These signs can help doctors make the correct diagnosis during an asthma attack. […] Test results are more reliable to diagnose and assess asthma attacks. Doctors will perform these tests while starting treatment. Some common tests during an asthma attack include: Peak flow measures how fast you can breathe out. […] Spirometry measures how much air you can breathe out. […] Pulse oximetry measures the amount of oxygen in your blood (called „oxygen saturation”). […] Blood tests can measure the amount of oxygen and carbon dioxide in your blood. Increased levels of carbon dioxide may indicate respiratory failure. […] Chest X-rays are commonly used to make sure you do not have another condition, such as a collapsed lung or pneumonia.
  • #2 Acute Severe Asthma | Cedars-Sinai
    https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/acute-severe-asthma.html
    Acute severe asthma is life-threatening. So quick diagnosis is important. Healthcare providers will ask about your symptoms. They will give you a physical exam. You may need these tests: […] Peak expiratory flow. This test can gauge lung function. […] Pulse oximetry. This test measures the level of oxygen in your body. […] Chest X-ray. This test may be done in severe cases. Or it may be done if your healthcare provider thinks you may have some other health problem.
  • #2 Asthma – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK430901/
    Patients showing airflow limitations on spirometry receive 2 to 4 puffs of a short-acting bronchodilator like albuterol, followed by repeat spirometry in 10 to 15 minutes. […] During bronchoprovocation testing, clinicians induce bronchoconstriction using inhaled methacholine or mannitol, exercise, or eucapnic hyperventilation of dry air. […] Eosinophilic airway inflammation causes an upregulation of nitric oxide synthase in the respiratory mucosa, leading to elevated nitric oxide levels in exhaled breath. In certain asthma patients, the fractional exhaled nitric oxide (FENO) surpasses levels observed in individuals without asthma. A FENO of measurement exceeding 40 to 50 ppb can aid in confirming an asthma diagnosis. […] Each patient should undergo a rapid assessment of their vital signs, including oxygen saturation. Measuring the peak flow can indicate the severity of the exacerbation and monitor the response to therapy. […] Most asthma-related deaths are preventable if risk factors are identified and addressed early. Major risk factors that place patients at high risk for future fatal asthma exacerbations include a recent history of poorly controlled asthma.
  • #2 Asthma Attack
    https://www.seattlechildrens.org/conditions/a-z/asthma-attack/
    Symptoms of an asthma attack are wheezing, a cough, tight chest, and trouble breathing. […] The diagnosis of asthma requires attacks of wheezing or trouble breathing that recur. The diagnosis is rarely made before 1 year of age. […] Moderate asthma symptoms (Yellow Zone). Some breathing problems. Tight chest. Wheezing. […] Call your doctor if rescue medicine is needed more often than every 4 hours. […] If treatment is started early, most asthma attacks are quickly brought under control. […] All wheezing should be gone by 5 days.
  • #2 Status Asthmaticus (Severe Asthma): Symptoms, Causes, Diagnosis, Treatment
    https://www.webmd.com/asthma/status-asthmaticus
    Status asthmaticus is respiratory failure that comes with the worst form of acute severe asthma, or an asthma attack. […] Your doctor will ask about your symptoms and how well you’re breathing. They’ll want to know if you have any fatigue or if you wheeze when you breathe in and out. They’ll check your pulse rate. You may also get tests such as a peak expiratory flow and an oxygen saturation, among others. […] With any asthma attack, you must start treatment right away, at the first sign of symptoms, either at home or in your doctor’s office. […] If your symptoms are severe and don’t go away after you follow your asthma action plan and use your medications as directed by your doctor, then call 911 and get emergency medical help.
  • #2 Asthma Differential Diagnoses
    https://emedicine.medscape.com/article/296301-differential
    Vocal cord dysfunction may exist alone or with asthma, it is caused by paradoxical adduction of the vocal cords during inspiration, and may disappear with panting, speech, or laughing. […] Patients with chronic symptoms suggestive of asthma, normal spirometry, poor response to asthma medications, and frequent evaluations should be evaluated for vocal cord dysfunction. […] Usually, the diagnosis can be made using direct laryngoscopy, but only during symptomatic periods or after exercise. […] The presence of flattening of the inspiratory limb of the flow-volume loop may also suggest vocal cord dysfunction, but this is only seen in 28% of patients at baseline. […] A variety of airway tumors are reported to manifest with symptoms similar to those of asthma. […] Other tracheal lesions can include bronchocentric granulomatosis, subglottic stenosis, subglottic web, tracheal hamartoma, bronchogenic cysts, leiomyoma, and tracheobronchopathia osteoplastica.
  • #2 Asthma Differential Diagnoses
    https://emedicine.medscape.com/article/296301-differential
    Foreign body aspiration may cause not only localized wheezing but also generalized wheezing. […] Wheezing occurs in toddlers as well as in adults. […] Pulmonary migraine consists of combined recurrent asthma; cough with thick mucoid sputum; lower back pain radiating to the shoulder; subtotal or total atelectasis of a segment or lobe; and, occasionally, nausea with vomiting. […] Congestive heart failure causes engorged pulmonary vessels and interstitial pulmonary edema, which reduce lung compliance and contribute to the sensation of dyspnea and wheezing. […] Cardiac asthma is characterized by wheezing secondary to bronchospasm in congestive heart failure, and it is related to paroxysmal nocturnal dyspnea and nocturnal coughing. […] Diffuse panbronchiolitis is prevalent in Japan and the Far East, and it may mimic bronchial asthma with wheezing, coughing, dyspnea on exertion, and sinusitis.
  • #2 How Chest X-rays Help with Asthma Screening and Diagnosis
    https://www.healthimages.com/chest-x-rays-help-asthma-screening/
    Asthma is a widely common, long-term condition affecting nearly 25 million people in the U.S. It causes swelling, inflammation and narrowing of the airways, making it difficult to breathe. […] Doctors can assess and diagnose people with asthma using many techniques, but chest x-rays are most frequently used when a patient is hospitalized or treated in the emergency room (ER) due to a severe asthma attack. […] Doctors dont typically use chest x-rays to directly diagnose asthma but rather to rule out other lung conditions. […] If you go to the hospital or ER after a severe asthma attack, you may need a chest x-ray to test for lung damage or other diseases. […] People with asthma can benefit from chest x-rays, as they can learn if they have another condition or infection thats aggravating their breathing difficulties.
  • #2 How Chest X-rays Help with Asthma Screening and Diagnosis
    https://www.healthimages.com/chest-x-rays-help-asthma-screening/
    If your healthcare provider suspects you have severe asthma, theyll perform additional testing to verify it or determine what else may be causing symptoms. […] A computed tomography (CT) scan is a computerized x-ray procedure that takes detailed images of the inside of your lungs. Medical professionals often use this exam for asthma diagnosis, as it can provide evidence of the condition. […] By showing what cells are present, a sputum test can help determine the cause of inflamed airways and the appropriate treatment option to pursue. […] After an asthma diagnosis, your doctor may recommend medications to help manage your symptoms and address the cause of your condition.
  • #2 Asthma Testing for Diagnosis and Treatment
    https://www.healthline.com/health/asthma/asthma-testing
    Blood samples with high levels of eosinophils (a type of white blood cell) and immunoglobulin E (IgE, a type of antibody) can indicate that you have asthma. […] Tests of your phlegm (also called sputum) can also look for high levels of eosinophils and help confirm a diagnosis of asthma. […] Having previous episodes of difficulty breathing or having close family members with asthma usually means that you’re more likely to develop asthma. […] A medical professional can use a stethoscope to listen to your lungs and airways as you breathe. […] If a bronchodilator, such as an albuterol rescue inhaler, helps relieve severe symptoms quickly, then you likely have asthma and not some other cause for your asthma symptoms. […] Most asthma tests aren’t accurate enough to be used on their own.
  • #2 Asthma in Children: Symptoms, Causes & Treatment
    https://my.clevelandclinic.org/health/diseases/6776-asthma-in-children
    Asthma is a lung disease that causes your airways to swell and narrow, making it very hard to breathe. […] If asthma isnt well controlled, it can cause a variety of issues and complications. […] Asthma can begin at any age, but it most often starts during childhood when your childs immune system is still developing. […] Asthma is the leading cause of chronic illness in children. […] Asthma is often difficult to diagnose in children, especially when theyre younger than age 6. […] Your childs pediatrician may diagnose the disease based on your childs medical history, symptoms and a physical examination. […] If possible, your childs provider may request a few tests to diagnose asthma. […] These tests may include lung (pulmonary) function tests, allergy skin testing and blood tests, and chest X-ray.
  • #2 Asthma Diagnosis and Testing – Allergy & Asthma Network
    https://allergyasthmanetwork.org/what-is-asthma/how-is-asthma-diagnosed/
    You cannot be diagnosed with asthma from home. An asthma diagnosis is a combination of several different factors. […] Diagnosing asthma in adults includes reviewing symptoms, family history and a physical exam. […] In children under the age of 5, most asthma lung function tests are not reliable. So asthma in young children is primarily diagnosed based on symptoms, family and health history, and a physical exam. […] Occupational asthma is diagnosed the same as other types of asthma. […] There are other types of respiratory conditions that are different than asthma.
  • #2 Patient education: Asthma symptoms and diagnosis in children (Beyond the Basics) – UpToDate
    https://www.uptodate.com/contents/asthma-symptoms-and-diagnosis-in-children-beyond-the-basics
    Challenge testing—a bronchial challenge test may be recommended to diagnose asthma. This testing is designed to cause the airways to narrow in children with asthma. […] Additional testing—Other tests may be recommended to ensure that another condition is not the cause of a child’s coughing or wheezing. […] Testing for young children—Infants and children younger than six years are usually not able to reliably perform spirometry or peak expiratory flow rate testing. In some cases, a health care provider may recommend a trial of asthma medication to confirm the diagnosis.
  • #2 Asthma: Types, Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/6424-asthma
    If you have asthma, you can still live a very productive life and participate in sports and other activities. Your healthcare provider can help you manage symptoms, learn your triggers and prevent or manage attacks. […] Your healthcare provider will work with you to develop an asthma action plan. This plan tells you how and when to use your medicines. It also tells you what to do based on your asthma symptoms and when to seek emergency care. […] If you have a severe asthma attack, you need to get immediate medical care. […] You should use the rescue inhaler when symptoms are bothering you and you can use it more frequently if your flare is severe.
  • #2 Understanding the Diagnosis and Treatment of Asthma
    https://www.lanermc.org/community/lane-health-blog/understanding-the-diagnosis-and-treatment-of-asthma
    Diagnosing asthma is not always straightforward because the symptoms can be similar to other respiratory conditions. […] To confirm an asthma diagnosis, doctors often use lung function tests. The most common test is spirometry, which measures how much air you can exhale and how fast you can blow air out. This test helps assess airway obstruction and the severity of your asthma. […] Your doctor will work with you to develop a personalized asthma action plan, which outlines how to manage your symptoms on a daily basis and what to do during an asthma attack. It typically includes instructions on when to use your inhaler, how to monitor symptoms, and when to seek emergency care. […] Early diagnosis and effective treatment can significantly improve your quality of life and prevent asthma attacks.
  • #2 How Is Asthma Diagnosed? | American Lung Association
    https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/symptoms-diagnosis/how-is-asthma-diagnosed
    Asthma is a disease that requires a diagnosis by a healthcare professional and ongoing assessments and monitoring throughout your lifetime. […] If you or your child experience symptoms such as wheezing, frequent cough, shortness of breath or chest tightness, it is important to see a healthcare provider to determine if the symptoms point to asthma. […] To diagnose asthma, a doctor will evaluate these symptoms, ask for complete health history, conduct a physical exam and look at test results. […] At the initial visit, your asthma care provider will determine your level of severity and create a treatment plan. At each follow-up visit, they will assess your asthma control and adjust your treatment plan as needed. […] Lung function tests are often used to make an asthma diagnosis, but they are very hard to do with young children. The doctor may use a 4- to 6-week trial of asthma medicines to see if they make a difference in your child’s symptoms. […] If you are diagnosed with asthma, you and your doctor will discuss a treatment plan just for you, including the use of medicines.
  • #3 Asthma Differential Diagnoses
    https://emedicine.medscape.com/article/296301-differential
    Aortic arch anomalies may occur later in adulthood. […] Sinus disease, especially in children, is associated with bronchial asthma and wheezing. […] The incidence of GER in patients with asthma ranges from 38% in patients with only asthma symptoms to 48% in patients with recurrent pneumonia. […] Consideration for alternative diagnoses should be given in all patients, and in particular in those older than 30 years and younger than 2 years with new symptoms suggestive of asthma. […] An absence of airway obstruction on initial spirometry findings should prompt consideration for alternative diagnoses and additional testing.