Asthma Diagnosis

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Asthma Diagnosis
Asthma Diagnosis
Video: Asthma Diagnosis
Video: Symptoms and Diagnosis of Asthma 2023, February
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Asthma: diagnosis

Many lung diseases are often only recognized at a relatively late stage. However, early diagnosis is crucial for the response to therapy and for the long-term course of the disease. This can subsequently enable the patient to enjoy a better quality of life. If bronchial asthma is suspected (e.g. in the case of persistent coughing), an examination of the lungs and airways should be carried out immediately. If possible, the severity of the disease should be determined and the cause of the symptoms identified.

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  • How is the diagnosis made?
  • Further investigations
  • Whom can I ask?
  • How are the costs going to be covered?

How is the diagnosis made?

The doctor gets an idea of ​​the disease through a detailed questioning of the patient. You will work particularly well with your doctor if you convey your information, observations and experiences to him / her. It therefore makes sense to take notes in advance of a doctor's visit. The conversation is mainly about answering the following questions:

  • Which diseases (especially of the respiratory tract) are known in your family?
  • Are there any known allergies or allergy-like diseases (e.g. neurodermatitis or hay fever)?
  • Do the symptoms change when they come into contact with animals, plants or food?
  • When did the symptoms first appear?
  • How have you been treated so far?
  • Which factors trigger the complaints?
  • When are the symptoms stronger or weaker: during the day or at night?
  • Do the symptoms arise with a seasonal dependence?
  • Do the complaints change in specific places, at work, when changing location or on vacation?
  • Do you or your relatives smoke? What is the effect of tobacco smoke if you smoke yourself or are in the same room with smokers?
  • What are the effects of physical exertion?

This provides the first important information about the type of disease and the selection of suitable further examination methods. If there is a possible allergic cause, a specific, individual anamnesis and examination is of particular importance because of the necessary targeted therapy. For more information, see Allergy Diagnostics. Furthermore, a thorough physical examination including listening (auscultation) and tapping (percussion) of the lungs is carried out. This determines the initial situation, which can also be of importance for the subsequent follow-up (improvement of the state of health, reduction of symptoms).

Further investigations

A pulmonary examination confirms the clinical diagnosis if asthma is suspected. The pulmonary function test is an important part. It provides information about the performance of the lungs using various methods.

Methods of pulmonary function diagnostics

Lung function is examined using the following methods:

  • Spirometry: is easy and inexpensive to carry out. It is used for early detection, assessment of the severity and monitoring of the progression of lung diseases. The air volume and air flow speed are measured when inhaling and exhaling.
  • Bronchospasmolysis test: is used when a narrowing of the bronchi has been determined by means of spirometry and provides information about the extent to which the narrowing of the bronchi can be reversed. For this purpose, a bronchodilator drug (bronchospasmolytic) is inhaled after the spirometry and the measurement is repeated a little later. If the lung function test with such a substance is significantly better, this underlines the diagnosis of "bronchial asthma". This test is also meaningful for further therapeutic steps. After the spirometry and bronchospasmolysis test have been carried out, further lung function tests are rarely necessary.
  • Whole-body plethysmography: This measurement takes place in a closed cabin. It is more complex in terms of equipment, but enables special and particularly precise measurements. It is considered to be the safest way to differentiate asthma from other diseases that impair lung performance (e.g. pulmonary fibrosis). The use of this procedure makes sense if all previous examinations have not produced any clear results.

Additional research methods

These are used in particular in the event of an acute asthma attack or if the results of the previous diagnostics are inconclusive.

  • Reversibility test: If the result of the spirometry shows a narrowing of the airways typical of asthma, a reversibility test should be carried out to clarify the diagnosis. For this purpose, lung function is measured again after a drug is administered that dilates the narrowed bronchi. If this result is better than before the drug was taken, it has worked. Then the diagnosis of asthma can be made with high probability.
  • Provocation test: If asthma is highly suspected - but lung function is normal at the time of the examination - an inhalative provocation test can be useful in rare cases. It is used to determine the tendency to asthma by inhaling a substance that leads to the temporary constriction of the bronchi, or by means of physical stress.
  • Blood gas analysis: A blood gas analysis can measure the oxygen content of the blood and indicate disturbances in the gas exchange in the lungs. It provides information about the severity and thus the degree of risk as well as the prognosis for bronchial asthma. In most cases, blood is taken from the earlobe and then - among other parameters - the oxygen and carbon dioxide content of the blood is determined in a device.
  • EKG: During this examination, heart current curves are recorded. The EKG is of central importance in the diagnosis of heart disease. Cardiac arrhythmias and circulatory disorders are possible findings. In addition, however, the examination can also provide indications of right heart overload as a possible consequence of a lung disease. Such an ECG pattern is also often seen in an acute asthma attack. In addition, the EKG is used to rule out a heart disease as the cause of an existing shortness of breath.
  • Imaging procedures: An X-ray of the organs of the chest (heart, lungs, blood vessels) can be useful for the initial diagnosis of bronchial asthma, especially to differentiate it from other diseases. In the case of severe bronchial asthma, further imaging examinations such as computed tomography can be useful.

Whom can I ask?

For regular examinations of the airways and lungs, please contact your family doctor. If necessary, a referral to a specialist in pulmonology or to a special outpatient clinic may be necessary.

How are the costs going to be covered?

All necessary and appropriate diagnostic measures are taken over by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB).

However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

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