Exercise-Induced Dyspnea in Children and Adolescents: Differential Diagnosis.

Abstract:

:Exercise-induced dyspnea in children and adolescents can occur for many reasons. Although asthma is the common cause, failure to prevent exercise-induced asthma by pretreatment with a bronchodilator, such as albuterol, indicates that other etiologies should be considered. Other causes of exercise-induced dyspnea include exercise-induced vocal cord dysfunction, exercise-induced laryngomalacia, exercise-induced hyperventilation, chest wall restrictive abnormalities, cardiac causes, and normal physiologic limitation. When exercise-induced dyspnea is not from asthma, cardiopulmonary exercise testing with reproduction of the patient's dyspnea is the means to identify the other causes. Cardiopulmonary exercise testing monitors oxygen use, carbon-dioxide production, end-tidal pCO2 (partial pressure of carbon dioxide), and electrocardiogram. Additional components to testing are measurement of blood pH and pCO2 when symptoms are reproduced, and selective flexible laryngoscopy when upper airway obstruction is observed to specifically identify vocal cord dysfunction or laryngomalacia. This approach is a highly effective means to identify exercise-induced dyspnea that is not caused by asthma. [Pediatr Ann. 2019;48(3):e121-e127.].

journal_name

Pediatr Ann

journal_title

Pediatric annals

authors

Bhatia R,Abu-Hasan M,Weinberger M

doi

10.3928/19382359-20190219-02

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

e121-e127

issue

3

eissn

0090-4481

issn

1938-2359

journal_volume

48

pub_type

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