Asthma differential diagnosis
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Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [1]; Philip Marcus, M.D., M.P.H. [2]
Overview
Asthma must be clinically differentiated from other conditions that cause recurrent cough and wheezing such as viral bronchiolitis, chronic obstructive pulmonary disease, congestive heart failure, vocal cord dysfunction, and allergic rhinitis.
Differentiating Asthma from other Diseases
- Although, many cases of recurrent cough and wheezing in children and adults are due to asthma, other conditions are often misdiagnosed as asthma.[1]
Adults
- Chronic obstructive pulmonary disease (COPD)
- Hyperventilation syndrome and panic attacks
- Congestive heart failure
- Pulmonary embolism
- Laryngeal dysfunction
- Pulmonary aspiration
- Mechanical obstruction of the airways (benign and malignant tumors)
- Pulmonary infiltration with eosinophilia
- Diffuse parenchymal lung diseases
- Cough secondary to drugs (ACE inhibitors)
- Vocal cord dysfunction[1]
Infants & Children
Upper airway diseases
Obstructions involving large airways
- Foreign body in trachea or bronchus
- Vocal cord dysfunction
- Vascular rings or laryngeal webs
- Laryngotracheomalacia, tracheal stenosis, or bronchostenosis
- Enlarged lymph nodes or tumor[1]
Obstructions involving small airways
Other causes
- Congenital heart diseases
- Recurrent cough not due to asthma
- Aspiration from swallowing mechanism
- Gastroesophageal reflux[1]