Chest pain and non-respiratory symptoms in acute asthma

The frequency and characteristics of chest pain and non-respiratory symptoms were investigated in patients admitted with acute asthma. One hundred patients with a mean admission peak flow rate of 38% normal or predicted were interviewed using a questionnaire. Chest pain occurred in 76% and was characteristically a dull ache or sharp, stabbing pain in the sternal/parasternal or subcostal areas, worsened by coughing, deep inspiration, or movement and improved by sitting upright. It was rated at or greater than 5/10 in severity by 67% of the patients. A wide variety of upper respiratory and systemic symptoms were described both before and during the attack. Non-respiratory symptoms occur commonly in the prodrome before asthma attacks and become more frequent after onset of the attack. Chest pain is usual during asthma attacks. Although it is benign and self limiting it may cause diagnostic confusion and patient distress.