Diseases with symptoms that are similar to Asthma

If you have symptoms such as wheezing, coughing or shortness of breath, this does not mean that you have asthma. Other diseases may have symptoms that are very similar to those of asthma. Let’s look at some of these “imitators.”

Diseases with symptoms that are similar to Asthma

Since the same symptoms may apply to asthma and other diseases, your healthcare provider should conduct a thorough examination to make sure that these symptoms refer specifically to asthma.

Diseases with similar symptoms:

  • Sinusitis: also called an infection of the nasal sinuses; it is an inflammation or swelling of the nasal sinuses. Sinusitis and asthma often coexist.
  • Myocardial ischemia: heart disease, which is characterized by impaired blood circulation in the muscle tissues of the heart.
  • Embolism of the lungs: clots of blood in the pulmonary arteries.
  • Gastroesophageal reflux disease (GERD): a disorder in which the contents of the stomach and stomach acid enter the esophagus, causing heartburn. Heartburn can cause an exacerbation of asthma symptoms.
  • Angina pectoris: chest pain due to lack of blood flow to the heart.
  • Chronic Obstructive Pulmonary Diseases (COPD): a common term that unites several lung diseases, the most common of them are emphysema and chronic bronchitis, triggered by exposure to tobacco smoke.
  • Chronic bronchitis: irritation and inflammation (edema) of the respiratory tract, is also considered a form of COPD, triggered by exposure to tobacco smoke.
  • Bronchiectasis: a disease of the lungs, which is characterized by damage to the walls of the respiratory tract in the lungs; the main cause is a recurring infection.
  • Acute heart failure: a heart disease in which the heart badly pushes blood, which leads to the filling of the lungs with fluid.
  • Abnormality of the upper respiratory tract: a disease in which air passage is impossible due to a blockage of something, including an enlarged thyroid gland or tumors.
  • Vocal cord dysfunction: A disease in which the muscles of the respiratory neck (the vocal apparatus) rapidly contract, causing respiratory problems.
  • Paralysis of the vocal cords: the vocal cords cease to perform their functions.
  • Bronchogenic cancer: lung cancer.
  • Aspiration: sudden penetration of a foreign body, for example, food, with inhalation in the respiratory tract.
  • Aspergillosis of the lungs: fungal infection of lung tissue.
  • Respiratory syncytial virus(RSV): this virus can cause causative bronchitis and pneumonia in children and can trigger the development of pediatric asthma.

How to identify “imitators” of asthma and put the right diagnosis?

To make the right diagnosis and make sure that the symptoms are not caused by any other illnesses, your doctor will study your medical history, your family’s hereditary diseases and, of course, the symptoms. The doctor will be interested in the smallest details of the problems associated with shortness of breath in the past, as well as a hereditary predisposition to asthma or other lung diseases, allergies or skin diseases, for example, eczema, which is closely related to allergies. It is very important to describe in detail your symptoms (cough, wheezing, shortness of breath, chest tightness), including when and how often they appear.


The doctor will definitely ask if you smoke or smoked before. Smoking and asthma are incompatible. Smoking is another major factor in the development of symptoms (COPD (chronic obstructive pulmonary disease) and cancer), similar to asthma. You will also be asked if you ever encountered harmful chemicals, for example, at work.

The doctor will also conduct a thorough examination, including lung function tests, allergic reaction tests, lung and nasal x-rays. All these tests will help the doctor determine if you have asthma or another disease that looks like asthma in symptoms.

What is a test of pulmonary function?

The pulmonary function test (TLF or lung function test) includes several tests to identify lung problems. The two most common of these are spirometry and a test with a load of methacholine. These two tests plus the medical history and physical examination are fundamental in the diagnosis of asthma.

  • Spirometry. This is a simple test, during which the volume of lungs and the speed of exhaled air are measured. Blockade of the respiratory tract due to asthma or COPD quickly resolves. Spirometry is performed before and after inhalation of albuterol, bronchodilator. Albuterol is a part of the inhaler and helps to expand the airways. If, after taking albuterol, the airways expand, this indicates the presence of asthma or COPD. The doctor may conduct several additional tests to determine the type of asthma.

This test is also used for further monitoring of the course of the disease and helps the doctor develop a treatment program.

  • Measurement of air volume. In a simple spirometry test, you only need to exhale all the air from the lungs, but some additional actions are performed to measure the air volume. This test determines the blockage of the airway in the neck, for example, paralysis or vocal cord dysfunction.

    Such narrowing of the upper respiratory tract can be confirmed by computed axial tomography of the neck.

  • Test with a load of methacholine. If pulmonary function tests have shown normal results, then you may have a weak form of intermittent asthma. To confirm this, the doctor can offer a test with a load of methacholine. During this test, you inhale each time an increasing amount of methacholine before and after spirometry. If lung function decreased by 20% and more after a small dose of methacholine, this indicates the presence of asthma. This decrease in lung capacity cannot lead to an attack of asthma, and yet after testing you need to take albuterol, which neutralizes the effect of methacholine.
  • Diffusion capacity of blood. During this test, you need to hold your breath for 10 seconds to determine how well the lungs are supplied with blood. The results of the test for diffuse blood capacity are normal in asthmatics, but below the norm in smokers with COPD.

What is the chest x-ray?

Thanks to the radiography, the doctor can find out if you have other diseases that can provoke symptoms similar to those of asthma. Asthma can cause a slight increase in lung size (which is called excessive enlargement), but asthmatics often have radiographic results normal. Patients with COPD (chronic obstructive pulmonary disease) may also experience excessive lung enlargement, but with emphysema, holes in the lungs are formed, called bullae or water bubbles, which are especially visible on X-rays. Radiography of the chest can also confirm the presence of pneumonia or lung cancer, especially in smokers.

Other tests for asthma-like conditions

There are several other diseases that, in addition, complicate the diagnosis, but also complicate the treatment and control of asthma. These diseases include allergies and GERD. If you have asthma, the doctor must check you for these diseases or prescribe a treatment for several weeks, which will show whether asthma symptoms decrease from it or not.

Diseases with symptoms that are similar to Asthma
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