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The diagnosis of asthma is made by the pulmonologist or immunoallergologist by assessing the symptoms presented by the person, such as severe cough, shortness of breath and tightness in the chest, for example. In some cases, only the assessment of symptoms is sufficient to confirm the diagnosis, especially if there is a family history of asthma or allergies.
However, the doctor can also indicate the performance of other tests in order to check the severity of asthma, as this is also possible for the doctor to indicate the most appropriate treatment.
1. Clinical evaluation
The initial diagnosis of asthma is made by the doctor through the evaluation of signs and symptoms presented by the person, in addition to the evaluation of family history and the presence of allergies, for example. Thus, the symptoms that can help confirm the diagnosis of asthma are:
- Severe cough;
- Wheezing when breathing;
- Feeling of shortness of breath;
- Feeling of "chest tightness";
- Difficulty filling your lungs with air.
Asthma attacks also tend to be more frequent at night and can cause a person to wake up from sleep. However, they can also happen at any other time of the day, depending on the triggering factor. Check for other symptoms that may indicate asthma.
What to tell the doctor in the evaluation
Some information that can help the doctor to arrive at the diagnosis more quickly, in addition to the symptoms, include the duration of the crises, the frequency, intensity, what was being done at the moment when the first symptoms appeared, if there are other people in the family with asthma and if there is an improvement in symptoms after taking some type of treatment.
2. Exams
Although in most cases asthma is diagnosed only by assessing the signs and symptoms presented, it is indicated in some cases to perform tests, mainly with the aim of verifying the severity of the disease.
Thus, the test normally indicated in the case of asthma is spirometry, which aims to identify the presence of narrowing of the bronchi, which is common in asthma, by assessing the amount of air that can be exhaled after deep breathing and how quickly the air is expelled out. Normally, the results of this examination indicate a decrease in FEV, FEP values and in the FEV / FVC ratio. Learn more about how spirometry is performed.
After making the clinical evaluation and spirometry, the doctor may also resort to other tests, such as:
- Chest X-ray;
- Bloodtests;
- Computed tomography.
These exams are not always used, as they serve especially to detect other lung problems, such as pneumonia or pneumothorax, for example.
Criteria for diagnosing asthma
To make the diagnosis of asthma, the doctor generally relies on the following parameters:
- Presentation of one or more asthma symptoms such as shortness of breath, coughing for more than 3 months, wheezing when breathing, tightness or pain in the chest, especially at night or in the early hours of the morning;
- Positive results on tests to diagnose asthma;
- Improvement of symptoms after the use of asthma drugs such as bronchodilators or anti-inflammatory drugs, for example;
- Presence of 3 or more episodes of wheezing when breathing in the last 12 months;
- Family history of asthma;
- Exclusion of other diseases such as sleep apnea, bronchiolitis or heart failure, for example.
After the doctor diagnoses asthma using these parameters, the severity and type of asthma is determined, and thus, the most suitable treatment for the person can be indicated.
How to know the severity of asthma
After confirming the diagnosis and before recommending treatment, the doctor needs to identify the severity of the symptoms and understand some of the factors that appear to lead to the onset of the symptoms. In this way, it is possible to better adapt the doses of medicines and even the type of medicines used.
The severity of asthma can be classified according to the frequency and intensity with which the symptoms appear in:
| Light | Moderate | Serious |
Symptoms | Weekly | Daily | Daily or continuous |
Waking up at night | Monthly | Weekly | Almost daily |
Need to use a bronchodilator | Eventual | Daily | Daily |
Activity limitation | In crises | In crises | To be continued |
Crises | Affect activities and sleep | Affect activities and sleep | Frequent |
According to the severity of asthma, the doctor guides the appropriate treatment that usually involves the use of asthma remedies such as anti-inflammatory and bronchodilator remedies. See more details on asthma treatment.
Factors that normally contribute to an asthma attack include respiratory infections, changes in the weather, dust, mold, some tissues or the use of medications. During the treatment it is important to avoid the factors identified to avoid the appearance of new crises and even decrease the intensity of symptoms, when they appear.
Although some triggering factors can be identified at the time of diagnosis, others can be identified over the years, it is always important to inform the doctor.