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 pulmonary conditions with similar symptoms such as chronic obstructive pulmonary disease and pulmonary aspiration.
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.
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
Infants & Children
Upper airway diseases
- Allergic rhinitis and sinusitis
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
Obstructions involving small airways
- Viral bronchiolitis or obliterative bronchiolitis
- Cystic fibrosis
- Bronchopulmonary dysplasia
Other causes
- Congenital heart diseases
- Recurrent cough not due to asthma
- Aspiration from swallowing mechanism
- Dysfunction or gastroesophageal reflux