Differential Diagnosis of Asthma in Adults


Asthma is a common respiratory disease affects on average 5% of the population during the last two decades incidence of the disease is increased about 40% Although the pathophysiology of asthma is better known and new medications are available unfortunately the morbidity of the disease is also Increased about 40% that the causes may be the following :

1.                1. Incompliance of the patient to  physician.

2.                2. Under treatment by the physician.

3.                3. Incorrect diagnosis.

Today asthma is known as a syndrome that its spectrum is from cough asthma to impending respiratory failure and even death.

Clasic asthma symptoms presentation are cough, dispnea and wheezing that may be seen in other diseases or disorders on physical examination . When the asthma doesn’t response to properly treatment one should revise about the diagnosis of asthma. the following are in differential diagnosis of broncial asthma that some of them are mentioned in literature and some of them I encountered during of my practice. differential diagnosis asthma becomes difficult when the two disease are present coincidentally.

Cronic Obstructive pulmonary disease.
Congestive heart failure especially due to mitral stenosis.
Infectious disease including bronchiectasis , sinusitis , tuberclosis.
-  Sarcoidosis
Pulmonary thromboemboli
Extrinsic allergic alveolitis associated  with occupational asthma.
Forign body aspiration
Tracheal compression by mass thyroid…
Aortic Anorism
Right sided aorta
Respiratory  airway dysfunction syndrome (RADS)
Largnyeal edema
Largnyeal mass
Vocal cord paralysis
Hiatal hernia
Luxation or subluxation of arythenoid cartilage

-     By taking a good history and physical examination and use of paraclinic including CXR, spirometry, peak flow meter one can differentiate bronchial asthma from other diseases and treat properly.


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