Advertisement

Shortness of Breath, Chest Tightness, and Wheezing

  • Taher CheraghiEmail author
Chapter

Practical Points

  • Episodic wheezing and dyspnea, nocturnal coughs, positive family history of atopy, worsening of symptoms following respiratory viral infections, and after exposure to inhalant allergens point to a diagnosis of asthma

  • Wheezing appearing soon after birth with constant nature, associated with failure to thrive, pulmonary consolidation, and poor response to asthma medications, are against a diagnosis of asthma

  • Wheezing is not a constant feature of asthma and patients might present with an essentially normal clinical picture between episodes of exacerbation

  • Oxygen supplementation and administration of SABA are the two most crucial measures to mitigate asthma exacerbations

  • A fall in FEV1 by 15% or more following bronchoprovocation, or rise in FEV1 by 12% or 200ml after inhalation of short acting beta agonist is diagnostic for bronchial hyperreactivity

Keywords

Asthma Forced vital capacity Forced expiratory volume in 1 s 

References

  1. 1.
    National Asthma E, Prevention P. Expert panel report 3-guidelines for the diagnosis and management of asthma full report. 2007. https://www.nhlbi.nih.gov/health-pro/guidelines/current/asthma-guidelines/full-report.
  2. 2.
    Strunk LBBRC. Asthma in older children: special considerations. In: Leung DY, Szefler SJ, Akdis CA, Bonilla FA, Sampson H, editors. Pediatric allergy: principles and practice: Elsevier Health Sciences; 2016. p. 311–28.Google Scholar
  3. 3.
    GINA-2017-main-report-final_V2.pdf. 2017. www.ginasthma.org.
  4. 4.
    Andrew H, Joseph D, Spahn SHS. Childhood asthma. In: Kliegman RM, Blum NJ, Shah SS, ST Geme JW, Tasker RC, Wilson KM, editors. Nelson textbook of pediatrics. 2-volume set. Medicine. 21st ed. Philadelphia: Elsevier; 2020. p. 1932–57.Google Scholar
  5. 5.
    Sheikh A, O’Hehir R, Holgate S, editors. Middleton’s allergy essential. Amsterdam: Elsevier; 2016.Google Scholar
  6. 6.
    Adkinson NF Jr, Bochner BS, Burks AW, Busse WW, Holgate ST, Lemanske RF, O’Hehir RE. Middleton’s allergy E-book: principles and practice. Amsterdam: Elsevier; 2013.Google Scholar
  7. 7.
    Ali Altalag JR, Wilcox P. Pulmonary function tests in clinical practice. New York, NY: Springer; 2009.Google Scholar
  8. 8.
    Gold WM, Koth LL. Pulmonary Function Testing. In: Murray JF, Nadel JA, editors. Textbook of respiratory medincine. 6th ed. Philadelphia: Saunders; 2016.Google Scholar
  9. 9.
    Thomas M, Wilkinson T. Asthma diagnosis in the community—time for a change? Clin Exp Allergy. 2014;44(10):1206–9.CrossRefGoogle Scholar
  10. 10.
    Brozek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, Brignardello-Petersen R, Canonica GW, Casale T, Chavannes NH, Correia de Sousa J, Cruz AA, Cuello-Garcia CA, Demoly P, Dykewicz M, Etxeandia-Ikobaltzeta I, Florez ID, Fokkens W, Fonseca J, Hellings PW, Klimek L, Kowalski S, Kuna P, Laisaar KT, Larenas-Linnemann DE, Lodrup Carlsen KC, Manning PJ, Meltzer E, Mullol J, Muraro A, O’Hehir R, Ohta K, Panzner P, Papadopoulos N, Park HS, Passalacqua G, Pawankar R, Price D, Riva JJ, Roldan Y, Ryan D, Sadeghirad B, Samolinski B, Schmid-Grendelmeier P, Sheikh A, Togias A, Valero A, Valiulis A, Valovirta E, Ventresca M, Wallace D, Waserman S, Wickman M, Wiercioch W, Yepes-Nunez JJ, Zhang L, Zhang Y, Zidarn M, Zuberbier T, Schunemann HJ. Allergic rhinitis and its impact on asthma (ARIA) guidelines—2016 revision. J Allergy Clin Immunol. 2017;140(4):950–8.CrossRefGoogle Scholar
  11. 11.
    Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CPM, Gustafsson P, Hankinson J, Jensen R, Johnson DC, MacIntyre N, McKay R, Miller MR, Navajas D, Pedersen OF, Wanger J. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948–68.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Pediatrics, 17th Shahrivar Children’s Hospital, School of MedicineGuilan University of Medical SciencesRashtIran

Personalised recommendations