Not all who wheeze have asthma

Educational aims

1. Exercise-induced asthma is frequently found among children, adolescents and young adults.

2. The diagnosis of asthma should be documented by variable lung function, airway hyperresponsiveness and inflammation.

3. Not all people who report exercise-induced respiratory symptoms have asthma.

Summary Asthma is characterised by respiratory symptoms such as shortness of breath and wheezing, and by exercise-induced symptoms. People with asthma frequently report symptoms during exercise; 90% of these people have exercise-induced asthma (EIA). Nevertheless, exercise-induced symptoms may mask other conditions or diseases, for instance poor physical fitness, exercise-induced laryngeal obstruction, hyperventilation and cardiomyopathy. Asthma symptoms should be documented and patients treated accordingly. With non-asthmatic exercise-induced symptoms, diseases in the laryngeal area are highly likely and patients should be examined while running. Although treatment options for laryngeal dysfunctions are limited, patients feel more in control when they know what is happening in their throat.