Clinical features of asthma

Asthma patients present with characteristic symptoms such as wheezing, shortness of breath (dyspnea), chest tightness or cough (with or without sputum) that vary over time and intensity, together with variable expiratory airflow limitation

• combinations of symptoms and signs are clinically more helpful than isolated symptoms, especially in children.
  • e.g. - two thirds of children with a cluster of cough, wheeze, chest tightness, dyspnoea, and exercise symptoms have asthma. Asthma is very unlikely if a child does not have at least some of these symptoms and signs ) (1,2)

The following symptoms, if present, increase the probability of a diagnosis of asthma in a patient:

• more than one symptom (wheeze, shortness of breath, cough, chest tightness), especially in adults
• worsening of symptoms in the night or early morning
• symptoms vary overtime and intensity
• symptoms are triggered by viral infections (cold), exercise, allergen exposure, changes in weather, laughter or irritants (smoke, strong smell)

The following decrease the probability that respiratory symptoms are due to asthma:

• isolated cough in the absence of other respiratory symptoms
• chronic production of sputum
• shortness of breath associated with dizziness, light headedness or peripheral tingling (paresthesia)
• chest pain
• exercise induced dyspnoea with noisy inspiration

Clinical features are divided here into:

• general clinical features
• features suggestive of a severe attack
• clinical features in childhood

Reference:

• (1) British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) 2019. British Guideline on the Management of Asthma. A national clinical guideline (Accessed March 2024)
• (2) Global Initiative For Asthma (GINA) 2023. Global strategy for asthma management and prevention