Diagnosis and management of exercise-induced asthma

Exercise-induced asthma (EIA) affects 12% to 15% of the general population. Its symptoms include chest tightness, shortness of breath, coughing, wheezing, fatigue, and prolonged recovery times after exercise. Diagnosis depends on accurate history, physical examination, and lung function testing. Nonpharmacologic management includes modification of both activity and ambient conditions, along with rigorous patient education. Short-acting inhaled beta2 agonists are the pharmacologic treatment of choice for isolated and breakthrough EIA. Anti-inflammatory medications such as inhaled cromolyn sodium, nedocromil sodium, and corticosteroids are used to control underlying asthma as well as EIA. Other agents such as oral theophylline or long-acting beta agonists may be important but their roles aren't clearly defined.