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Friday, August 1, 2014
What Tests Can Diagnose Asthma?
My husband has been off of work for some time due to shortness of breath. He is a truck driver, delivering food produce, which is very physical and requires heavy lifting, pulling, pushing, etc. My husband gets shortness of breath upon exertion.
When he is on the treadmill after a few minutes, he gets chest and throat tightness and short winded. He also has upper abdominal pain. He has had numerous tests: chest x-rays, stress test, endoscopy, angiogram, echocardiogram, pulmonary function test, bronchial challenge test, CT scan of chest, ultrasound of abdomen and blood work. All are coming back normal. He has been exposed to various irritants such as molds, formaldehyde and smoke from burning of brush. He is a smoker (1 pack a day for 30 years). Do you have any thoughts on possible cause or any other tests that can be done?
As you know, there is no one test for asthma. The diagnosis of asthma can be a challenge and usually involves a history of symptoms, pulmonary function testing, CXR, and sometimes also requires a bronchial challenge test to demonstrate airway hyperresponsiveness. Smoking makes this even more challenging as differentiating between smoking induced lung disease and asthma is at times very difficult and people with asthma who also smoke can develop a combination of the two disease processes.
Your husband has had many tests which would be used to detect evidence of asthma and it is unlikely another test would offer much to these results but of course that also all depends upon the results of all of these tests. I would consider asking for an evaluation at a tertiary care center where they are often used to seeing patients with complex symptoms and difficult diagnosis.
John G Mastronarde, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University