Diagnosing asthma is more complicated than you may think. While coughing, wheezing, and having trouble catching your breath are symptoms you can often blame on asthma, there are other health conditions — some of them surprising — that could mimic the symptoms of asthma and make diagnosis an even bigger challenge.
Asthma can cause other symptoms beyond just trouble catching your breath. These may include:
- Wheezing that worsens in colder temperatures, when exercising, or when you also have heartburn
- Wheezing that strikes suddenly then disappears
- Wheezing that gets worse early in the morning or at night
- Coughing, which could include coughing up phlegm
- A tight feeling in the chest or chest pain
- Unusual breathing patterns
- Flaring of the nostrils
- Retracting skin between the ribs when you breathe
Though these symptoms are all characteristic of asthma, they can also often signal another respiratory problem — or even another health problem unrelated to your respiratory health.
If It’s Not Asthma, What Is It?
Here are some other health problems that can cause similar symptoms to asthma:
- Chronic obstructive pulmonary disease, or COPD, an umbrella term for chronic bronchitis and emphysema: chronic bronchitis inflames the bronchial tubes; emphysema is characterized by loss of elasticity in the lungs
- Pneumonia, an infection of the lungs
- Pulmonary embolism, or a blood clot inside the lung
- Heart attack
- Congestive heart failure
- Environmental pollutants (like dust)
- Being obese or not getting enough exercise
- Having a panic attack
- Hiatal hernia, in which part of the stomach pushes into the chest and affects breathing
- Food aspiration — food sucked in to the respiratory tract when inhaling — due to difficulty swallowing
- Tumors in the lungs or the chest
Because there are so many possible causes for the symptoms of asthma, a number of tests will be performed to rule out any other potential causes. Your doctor will ask a lot of questions about your symptoms, ask about your personal and family medical history, and perform a complete physical exam to find out what's really at the root of your symptoms. He may ask questions about your smoking history or any allergies that you have.
Tests used to differentiate asthma from other conditions that cause similar symptoms include:
- Peak flow test — it measures how well air moves out of your lungs
- An X-ray or computed tomography (CT) scan of the chest
- Spirometry test — it measures how much air you breathe out, and how quickly
- Methacholine test — inhaling a chemical mist to see how it affects lung function
- Arterial blood gas — to determine the amount of oxygen in the blood
- Blood testing to look for immune system responses
- Echocardiogram or electrocardiogram
If it turns out asthma is the culprit, your doctor will know using these tests and can rule out any major heart problems or other health conditions before beginning to treat and manage your symptoms.
When it comes to your health, you want to get the best treatment possible. To do that, you have to start by getting the right diagnosis for your symptoms.