Hidden Asthma: Differences from Typical Asthma Symptoms

Latent asthma

Hello, doctor.
I would like to ask you about something.
When I was a child, a doctor mentioned that I had "latent asthma," but I didn't quite understand what that meant.
How does it differ from regular asthma? Is this term actually used? I only know that when I ran as a child, I would experience chest pain, shortness of breath, or sometimes chest tightness, and my airways were dilated, but I never experienced asthma attacks severe enough to cause shock or required the use of bronchodilator inhalers, nor did I receive any treatment.
Is that acceptable? What is the difference between asthma and regular shortness of breath? How can they be distinguished?

Mi Mi, 20~29 year old female. Ask Date: 2009/09/16

Dr. Yang Wenda reply Pulmonology

Dyspnea refers to "difficulty in breathing," which can be caused by various factors including chronic lung diseases, pneumonia, pneumothorax, as well as heart diseases and anemia.
Symptoms often worsen during physical activity.
"Asthma," correctly termed "bronchial asthma," is an inflammatory disease of the airways, typically associated with genetic predisposition.
Individuals may have a history of atopic dermatitis (scaling, dryness, skin rashes), allergic rhinitis, and family members with similar conditions.
Sometimes, a physician's assessment may be presumptive rather than definitive.
For clinical suspicion of bronchial asthma, patients can visit a pulmonology clinic for pulmonary function tests to check for obstructive airway disorders.
If necessary, specific provocative agents can be inhaled to induce bronchoconstriction, helping to diagnose potential hyperreactive airway conditions and confirm the presence of bronchial asthma.

Reply Date: 2009/09/16

More Info

Understanding "hidden asthma," or what is often referred to as "exercise-induced bronchoconstriction" or "latent asthma," is crucial for individuals who may not exhibit the classic symptoms of asthma but still experience respiratory issues under certain conditions. This condition can be particularly confusing, especially for those who have been diagnosed with asthma in childhood but do not experience the typical acute episodes that are commonly associated with the disease.

Asthma is a chronic inflammatory disease of the airways characterized by symptoms such as wheezing, coughing, chest tightness, and shortness of breath. These symptoms can vary in intensity and frequency, and they are often triggered by allergens, exercise, cold air, or respiratory infections. In typical asthma, patients may experience these symptoms regularly and may require the use of bronchodilators or inhaled corticosteroids for management.

In contrast, hidden asthma may not present with overt symptoms until specific triggers are encountered. For example, individuals with hidden asthma may only experience symptoms during physical exertion, such as running or playing sports, which can lead to chest pain, shortness of breath, or a feeling of tightness in the chest. These symptoms may not be as severe as those experienced by individuals with more classic forms of asthma, which can lead to a misconception that the condition is not serious or does not require treatment.

The term "hidden asthma" is not a formal medical diagnosis but rather a way to describe a situation where asthma symptoms are not readily apparent or are only triggered under certain conditions. It is essential to recognize that even if symptoms are not consistently present, the underlying airway inflammation associated with asthma can still be significant and may lead to long-term complications if left untreated.

Diagnosis of hidden asthma typically involves a thorough medical history, physical examination, and possibly lung function tests, such as spirometry. These tests can help assess how well the lungs are functioning and whether there is any obstruction in the airways. In some cases, a bronchoprovocation test may be conducted, where the patient is exposed to a known trigger (like exercise or a specific allergen) to see if it induces asthma-like symptoms.

Management of hidden asthma may involve the use of bronchodilators before exercise or exposure to known triggers, as well as long-term control medications if necessary. It is essential to work closely with a healthcare provider to develop an individualized asthma action plan that addresses both the acute and chronic aspects of the condition.

In summary, while hidden asthma may not present with the classic symptoms associated with typical asthma, it is still a significant condition that requires attention and management. Individuals who suspect they may have hidden asthma should seek evaluation from a healthcare professional, especially if they experience respiratory symptoms during exercise or other activities. Early diagnosis and appropriate management can help prevent complications and improve overall quality of life.

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