Word: asthma
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...study's findings come as no shock, says Dr. Norman Edelman, chief medical officer for the American Lung Association. The symptoms of wheezing and shortness of breath, which frequently get confused for asthma, may signal a host of other health problems, including the a respiratory infection, chronic obstructive pulmonary disorder, anxiety and congestive heart failure. In fact, congestive heart failure is so often misdiagnosed as asthma that lung experts often refer to it as "cardiac asthma," Edelman says. "All that wheezes is not asthma...
...dangers of misdiagnosing a patient's true condition are obvious. There are also potential risks of treating a nonexistent illness. Currently, more than 300 million people have asthma worldwide, with another 100 million patients anticipated by 2025. Unnecessarily treating people may have no impact at best, but it costs patients money and, worse, may expose them to harmful side effects for years or even decades. "The commonest medicines that we use are inhaled steroids," says Aaron. "They are very safe for patients with asthma, but are associated with long-term side effects, including osteoporosis, glaucoma and cataracts." The drugs...
...Aaron is quick to point out that even if patients suspect they have been misdiagnosed, they should stick with their medication until they consult their doctor. "I don't want patients to stop taking their medicine cold turkey," he said, emphasizing that the patients who ultimately went off their asthma drugs in his study did so over a period of several months while undergoing continuous tests to confirm the exclusion of asthma...
...solution to overdiagnosis, says Aaron, is simple: consistent, objective testing to identify asthma more accurately. A spirometry test, for example, measures the rate and volume of airflow during the patient's exhale, before and after using an inhaler. "If you came in with chest pain, [the physician] would do an electrocardiogram. If you came in complaining of high cholesterol they would do a blood test. But we're not measuring asthma before we start to throw medicines at it. We're making the diagnosis on spec, as it were...
...there is an established and often successful history in medicine of diagnosis by treatment. Says Edelman so-called "therapeutic trials" of asthma medication may be appropriate, based on a patient's symptoms and medical history - even without pulmonary tests. "If a 12-year-old kid comes into your office and says he wheezes every time he goes near his friend's dog, and you give him an inhaler and it never happens again, that's a therapeutic trial," he says...