Asthma Management Handbook
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Table. Findings that increase or decrease the probability of asthma in adults

Asthma is more likely to explain the symptoms if any of these apply

Asthma is less likely to explain the symptoms if any of these apply

More than one of these symptoms:

  • wheeze
  • breathlessness
  • chest tightness
  • cough

Symptoms recurrent or seasonal

Symptoms worse at night or in the early morning

History of allergies (e.g. allergic rhinitis, atopic dermatitis)

Symptoms obviously triggered by exercise, cold air, irritants, medicines (e.g. aspirin or beta blockers), allergies, viral infections, laughter

Family history of asthma or allergies

Symptoms began in childhood

Widespread wheeze audible on chest auscultation

FEV1 or PEF lower than predicted, without other explanation

Eosinophilia or raised blood IgE level, without other explanation

Symptoms rapidly relieved by a SABA bronchodilator

Dizziness, light-headedness, peripheral tingling

Isolated cough with no other respiratory symptoms

Chronic sputum production

No abnormalities on physical examination of chest when symptomatic (over several visits)

Change in voice

Symptoms only present during upper respiratory tract infections

Heavy smoker (now or in past)

Cardiovascular disease

Normal spirometry or PEF when symptomatic (despite repeated tests)

Adapted from:

Respiratory Expert Group, Therapeutic Guidelines Limited. Therapeutic Guidelines: Respiratory, Version 4. Therapeutic Guidelines Limited, Melbourne, 2009.

British Thoracic Society (BTS) Scottish Intercollegiate Guidelines Network (SIGN). British Guideline on the Management of Asthma. A national clinical guideline. BTS/SIGN, Edinburgh; 2012. Available from: https://www.brit-thoracic.org.uk/guidelines-and-quality-standards/asthma-guideline/.

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