Exercise-induced asthma: diagnosis and management

Objective: To review the diagnosis and management of exercise-induced asthma (EIA). Data Sources: Computer-assisted literature searches on MEDLINE for articles, abstracts, and other relevant data on exercise-induced asthma Study Selection: Published articles, abstracts, and conference proceedings were selected. Results: EIA is seen in 40 to 90% of asthmatic patients. Exercise can be the sole trigger or be one of multiple triggers of asthma exacerbations. A good history and physical examination can diagnose most cases of EIA. Spirometry can confirm the diagnosis. Exercise testing may be necessary in certain cases. Prevention through both pharmacologic and nonpharmacologic measures is the key to EIA management. Inhaled beta-agonists remain the medications of choice for EIA prophylaxis. Inhaled cromolyn and antileukotrienes are alternatives. Good long-term control of asthma with anti-inflammatory medications such as inhaled steroids will also decrease the incidence of EIA. Conclusions: Early diagnosis and proper preventive and maintenance therapy can reduce episodes of EIA and enable patients to continue to engage in sports and lead an active life.