In many patients, the diagnosis of asthma is straightforward and based upon intermittent combination of symptoms, most commonly including wheezing and tightness of the chest. In other patients, making the diagnosis can be more difficult, either because the classic symptom of wheezing is missing or patients do no respond to usual treatment (such as albuterol). In these patients, diagnostic testing is important and may include:
· Spirometry – a computerized breathing test performed by Allergy Medical Clinic which indicates whether your lung capacity and airflow through your lungs is normal. If the initial spirometry is abnormal, your physician will probably administer a bronchodilator drug (albuterol) to you to determine whether you improve after treatment.
· Nitric oxide test – another computerized test performed at Allergy Medical Clinic which measures actual inflammation in the bronchial tubes and may indicate that asthma is present even when the spirometry (above) is normal.
· Chest x-ray – may be important in ruling out other conditions, such as chronic pneumonia.
· Chest computed tomography (CT) – occasionally, an abnormality on the chest x-ray may indicate the need to do a second, more sensitive test. The chest CT is very good at picking up emphysema in the lungs as well as small masses, like tumors.
Based upon a combination of symptoms and spirometry, your physician will assess the severity level of your asthma as follows:
Symptoms and/or albuterol frequency Spirometry (FEV1) Level
<2 days per week >80% of predicted Mild intermittent
2-6 days per week >80% of predicted Mild persistent
Daily 60-80% of predicted Moderate persistent
Daily with frequent nighttime symptoms <60% of predicted Severe persistent
Dr. Jonathan Corren was born and raised in the Los Angeles area. He graduated from the University of California, Los Angeles, with honors in Biology and then completed his medical training at the University of California, San Diego, School of Medicine.