It is now over a century since Sir William Osler first highlighted the fact that not all breathlessness and wheeze is caused by asthma; with a description that in some, … ‘the laryngeal muscle can spasm during periods of stress’ and as such act to mimic bronchoconstriction.1
Yet despite 100 years of medical progress, when a young individual presents with exertional breathlessness, all too often he or she will get promptly labelled as asthmatic.2 3 Indeed, we know from studies conducted in both the UK3 and USA,4 that when faced with this clinical presentation, primary care physicians have poor access to the most accurate diagnostic tools and a trial of inhaled asthma therapy is often, therefore, employed with ‘diagnostic’ intent. This is despite the countless number of studies indicating that clinical assessment in this capacity is at best imprecise and at worst no better than a coin toss.5–7 In other words, in young individuals objective testing is required to determine the cause of their exertional breathlessness.
Publication information
Hull JH. Thorax 2015 Jan. 70(1): 7-8