Not Everybody That Wheezes, Coughs Or Has Trouble Breathing Has Asthma

April 12, 2010 - PRLog -- The Bronx is considered to be one of the epicenters of the asthma epidemic in the United States. Many people are familiar with asthma symptoms such as breathing difficulties and coughing. Asthma can be very severe and often leads to emergency room visits and hospitalizations. However, just because a person appears out of breath, makes wheezy respiratory sounds and coughs does not necessarily mean that he or she has asthma. Some health conditions have symptoms that may seem like asthma, but they are not.  They are often called “asthma mimics.” These conditions are also common and may include respiratory complications of gastroesophageal reflux disease (GERD), sinus infections, chronic obstructive pulmonary disease (COPD), laryngeal (voice box) and vocal cord problems.  Less commonly, symptoms of heart disease, pulmonary embolism, cystic fibrosis, aspiration of foreign bodies and even lung cancer may be at times confused with asthma.
   “Unfortunately, some people are misdiagnosed believing they have intractable asthma, when in fact they have a condition that mimics asthma,” said Krzysztof Nowak M.D., Asthma Specialist at the Morris Heights Health Center in the Bronx, New York. “Very often asthma can be a straight-forward diagnosis. However, common asthma symptoms, such as shortness of breath, for example, are present in many other respiratory and non-respiratory conditions. In addition, individual complaints often may be vague and unclear, which may easily mislead a physician. Failure to take a careful history, to rule out other possible conditions and obtain additional tests such as spirometry can lead to misdiagnosis. The spirometry test is used to measure how much air the lungs can hold and to show presence of bronchial obstruction (narrowing of the bronchi).”
   “Lack of improvement with standard treatment is also often overlooked as a possible clue that an improper diagnosis was reached. With the right treatment, the overwhelming majority of asthmatics can get their disease under excellent control,” added Dr. Nowak.      
   “Having asthma symptoms more than twice a week implies that the disease is not properly controlled,” emphasized Dr. Nowak. “Patients who do not respond well to standard medical treatment should be carefully re-evaluated to assure that, among others issues, their symptoms are not caused by one of the common asthma mimics.”
   One of the most common causes of chronic cough and breathing difficulties among adult patients who come to the Morris Heights Health Center for respiratory evaluation is acid reflux disease affecting the upper airway structures. Small amounts of acid cause severe irritation of the throat and larynx leading to persistent dry cough of various intensity. At times, the cough may be so severe that it wakes the sufferers at night in great distress. In a more severe form of this condition patients can develop vocal cord spasms. Affected individuals experience extreme breathing difficulties and often have panic reactions. Some patients fear that they may even die during such attacks. Since spasmodic vocal cords cause wheezy respiratory noises (properly called stridor), patients are often diagnosed and treated for asthma without much improvement. Most patients who suffer from laryngeal complications of GERD are easily treated with acid suppresant medications such as Prilosec, Prevacid or Nexium.
    Smokers are of great medical concern to all doctors. With time, about 15% to 25% of heavy smokers develop permanent damage of lung structures causing them to have chronic cough, wheezing and breathlessness during physical activities. This condition is called COPD or chronic obstructive pulmonary disease. Its presentations include chronic bronchitis and emphysema. Unfortunately, a lot of these patients are not well evaluated and most important are not properly informed of their condition. They often refer to themselves as “having asthma” when in fact they have a severe progressive disease that may lead to premature death.
   Dr. Nowak states, “That if a person’s asthma appears intractable, they should consider asking their doctor to review all their medications and take into consideration other possible diagnoses.”
About Morris Heights Health Center:
Morris Heights Health Center (MHHC) is a non-profit organization funded by federal, state and foundation grants and private and corporate donations. Since 1981, MHHC has been a major provider of health care to the Morris Heights section of the Bronx and the surrounding areas.  For more information, visit our website, www.mhhc.org.