1996 OPEN FORUM Abstracts
Other Disorders Often Mistaken for Asthma
John Heffner, MD Tuesday, November 5, 1996
The diagnosis of asthma rests on clinical grounds. In the absence of a specific diagnostic test, clinicians usually initiate therapy for asthma when patients present with wheezing, shortness of breath, and a course of symptoms characterized by recurrent remissions and exacerbations. This symptom complex, however, can be simulated by other disorders. Psychogenic conditions, such as vocal cord dysfunction, can produce recurrent wheezing associated with severe respiratory distress. Many of these patients may be managed for asthma and receive long-term corticosteroid therapy before the correct diagnosis is made. Upper airway obstruction can also simulate asthma. Close attention to the history and physical examination may identify patients who require imaging studies to exclude goiter, vocal cord paralysis, cricoarytenitis, and airway tumors. Systemic disorders, such as Churg Strauss syndrome and carcinoid syndrome, can also be misdiagnosed as asthma.