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Evaluating the Athlete with Suspected Exercise-Induced Asthma or Bronchospasm
Fred H Brennan1, Jeffrey Alent1, Michael J Ross1
1University of South Florida/BayCare Sports Medicine Fellowship, Clearwater, FL.
Current Sports Medicine Reports
|March 10, 2018
Summary
Exercise-induced asthma (EIA) and exercise-induced bronchospasm (EIB) affect up to 20% of the population. Accurate diagnosis requires spirometry and provocative testing, not just symptom-based empirical treatment.
Area of Science:
- Sports Medicine
- Pulmonology
- Clinical Exercise Physiology
Background:
- Exercise can trigger bronchial hyperresponsiveness in both asthmatics (EIA) and non-asthmatic athletes (EIB/EIC).
- Approximately 10-20% of the general population experience EIA or EIB.
- Recognizing clinical signs and selecting appropriate diagnostic tests are crucial for management.
Purpose of the Study:
- To outline the diagnostic approach for exercise-induced asthma and bronchospasm.
- To emphasize the importance of objective testing over empirical treatment.
Main Methods:
- Review of clinical signs and symptoms associated with exercise-induced bronchospasm.
- Recommendation for baseline spirometry and pulmonary function tests for athletes.
- Guidance on utilizing direct or indirect bronchial provocation testing for diagnosis.
Main Results:
- Baseline spirometry is recommended for all athletes to screen for underlying asthma.
- Provocative testing is essential for accurate diagnosis of EIA or EIB.
- Empirical treatment with bronchodilators based solely on symptoms is discouraged without confirmatory testing.
Conclusions:
- Accurate diagnosis of exercise-induced asthma and bronchospasm relies on objective testing.
- Clinicians must differentiate between EIA and EIB/EIC through appropriate diagnostic procedures.
- Confirmation via spirometry and provocative testing is necessary before initiating treatment.
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