Table of ContentsView AllTable of ContentsConditions Similar to AsthmaDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Conditions Similar to Asthma
Diagnosis
Treatment
Difficulty breathing—whether it’s wheezing, chest pain or tightness, shortness of breath, or coughing—ischaracteristic of asthma. But it can also occur with gastrointestinal reflux disease (GERD), chronic obstructive pulmonary disease (COPD), heart failure, viral infections, and other conditions.
As distressing as asthma can be, the disease rarely causes progressive lung damage. But other lung diseases that cause similar symptoms can, and they can worsen if not diagnosed and treated.
That’s why seeking a proper diagnosis is essential. You may have asthma if you have trouble breathing, particularly if your symptoms occur in episodes and flare up suddenly.A healthcare provider can differentiate asthma from other illnesses, often with the help of certain diagnostic tests.
This article will discuss the types of conditions that can cause symptoms similar to asthma. It also covers how your doctor can diagnose breathing problems and what treatments are available.
Theresa Chiechi / Verywell
Conditions That Mimic Asthma
There are a number of conditions that can cause shortness of breath, wheezing, coughing, and chest tightness. While most are lung disorders, some are associated with other organ systems, such as the heart.
When investigating your symptoms, your healthcare provider will consider all possible causes of your breathing difficulty using a process calleddifferential diagnosisthat considers potential causes, eliminating those that don’t fit with all of your symptoms and diagnostic tests.
Overview of Asthma
GERD
Fibrosis (lung scarring) is a long-term consequence of GERD-induced pneumonitis (also referred to as reflux-aspiration syndrome).
COPD
1:467 Differences Between COPD and Asthma
1:46
7 Differences Between COPD and Asthma
Chronic obstructive pulmonary disease (COPD)is a progressive lung disorder most commonly associated with smoking. In the early stages, COPD symptoms are similar to those of asthma and may flare if the lungs are exposed to allergens, fumes, or cold weather.
Symptoms of COPD that are not typically present with asthma include fluid retention, trouble sleeping, an increasing nagging cough, and bringing up clear, whitish, or yellow phlegm.
Differences Between Asthma and COPD
Congestive Heart Failure
Congestive heart failure (CHF)is a condition in which the heart does not pump strongly enough to supply the body with blood and oxygen.
CHF causes fatigue, pleural effusion (a buildup of fluid in the lungs),edema(swelling of the lower extremities), anddyspnea(shortness of breath).
Vocal Cord Dysfunction
Vocal cord dysfunctionis a condition in which the vocal cords stay closed while breathing. This makes it difficult to get air in or out of the lungs.
Vocal cord dysfunction typically causeshoarsenessalong with wheezing and a feeling of tightness and strangulation in the throat.
Hypersensitivity Pneumonitis
Hypersensitivity pneumonitis(HP) is an uncommon condition in which exposure to certain substances can lead to an allergic reaction in the lungs.
These substances can include things like moldy hay and bird droppings. Because HP has many of the same allergenic triggers as asthma, it can easily be mistaken for it.
HP may also cause flu-like symptoms, rales (crackling sound in lungs), weight loss, fatigue, and clubbing of the fingers and toes. Only allergy testing can confirm the diagnosis. Chronic HP cases may require alung biopsyfor diagnosis ifallergy testsare inconclusive.
Pulmonary Sarcoidosis
Tracheal Tumors
Tumors affecting the trachea (windpipe) can often start with asthma-like symptoms. Because they are so rare, tracheal tumors may be initially misdiagnosed as asthma.
Hemoptysis(coughing up blood) is often the first clue that something serious is involved. Tracheal tumors can either be benign (noncancerous) or malignant (cancerous). They typically require a biopsy to confirm the diagnosis.
Pulmonary Embolism
Pulmonary embolism (PE)is a condition in which a blood clot blocks an artery in the lungs. PE is associated with obesity, smoking, certain medications (including birth control pills), and prolonged immobility in a car or airplane.
Compared to asthma, wheezing is less common with PE. Chest pains tend to begin suddenly, feel sharp, and worsen when you cough or inhale. You may cough up pinkish bloody foam if you have PE.
Signs and Symptoms of Asthma
If you experience asthma-like symptoms, your healthcare provider may order some diagnostic tests to identify the cause.
Pulmonary function tests (PFTs) evaluate how well your lungs work. Imaging studies can check for abnormalities in your lungs and airways.
These diagnostic tests may include the following:
Based on the finding of these investigations, other tests may be performed. These includeendoscopy(a flexible tube with a camera to view internal organs), allergy tests, andlung biopsy.
In the end, three criteria must be met todiagnose asthma:
All other causes of airway obstruction, most especially COPD, need to be excluded before a formal asthma diagnosis can be made.
If you are diagnosed with asthma, your healthcare provider may prescribe some of the following treatments. Treatments can improve breathing in an emergency and prevent asthma attacks, or flare-ups, from happening again.
If asthma isnotthe cause of your breathing difficulties, other treatments will be considered based on your diagnosis. These can include chronic medications that manage symptoms of GERD, COPD, or CHF. Or it may involve a procedure to treat acute heart failure or a tumor.
Short-Acting Beta-Agonists
Short-acting beta-agonists (SABAs), also known as rescue inhalers, are commonly used to treat acute (sudden and severe) asthma symptoms. They can also treat respiratory impairment andacute exacerbations, or flare-ups, in people with COPD.
They are used for quick relief whenever you experience severe episodes of shortness of breath and wheezing. SABAs are also commonly inhaled before physical activity to prevent asthma symptoms during exercise.
Options include:
Inhaled Steroids
Inhaled corticosteroids, also referred to as inhaled steroids, are used to alleviate lung inflammation and reduce airway hypersensitivity to allergenic triggers.
Inhaled steroids are the most effective medications available for the long-term control of asthma.
Inhaled or oral corticosteroids are often included in treatment protocols for COPD and pulmonary sarcoidosis. Oral steroids may be used in emergency situations to treat severe asthma attacks.
Differences Between Inhaled and Oral Corticosteroids
Long-Acting Beta-Agonists
Long-acting beta-agonists (LABAs)are used along with inhaled steroids when asthma symptoms are not controlled with SABAs alone.If you experience difficulty breathing at night, a LABA can help you get more rest.
LABAs are also used along with inhaled corticosteroids for the daily management of COPD.
Anticholinergics
Anticholinergics are often used in combination with SABAs to treat respiratory emergencies. They are used for severe asthma attacks in combination with a SABA in the case of ipratropium. They are also used as add-on therapy for asthma maintenance in the case of Spiriva.
Anticholinergics used for bronchodilators include:
There is also a combination inhaler called Combivent that contains albuterol, a SABA, and the anticholinergic drug ipratropium.
Anticholinergics are also sometimes used to treat COPD. Tiotropium and ipratropium may increase the risk of a cardiovascular event, includingheart failure, in people who have COPD and an underlying heart condition.
Leukotriene Modifiers
Leukotriene modifiers are a class of drugs that may be considered if your healthcare provider thinks your asthma attacks are related to allergies. Although less effective than inhaled steroids, they may be used on their own if breathing problems are mild and persistent.
Three leukotriene modifiers are approved for use in the United States:
Some asthma medications are useful in treating other respiratory conditions. However, you should never use a drug prescribed for asthma for any other purpose without first speaking with your healthcare provider.
How Asthma Is Treated
Summary
Your doctor will order tests based on your symptoms. They may include imaging tests to look for structural lung abnormalities or pulmonary function tests to see how well your lungs work.
Based on the results of testing, your doctor can make a diagnosis and prescribe treatment.
Some treatments for asthma, including rescue inhalers and inhaled steroids, are sometimes used for conditions like COPD as well. However, you should always check with your doctor for a correct diagnosis before using asthma medication.
Is Asthma an Autoimmune Disease?
A Word From Verywell
What may seem like asthma is not always asthma. The only way to know for sure is to see a healthcare provider, such as apulmonologist(a lung specialist).
If you try to self-treat with an over-the-counter product likePrimatene Mist, any alleviation of symptoms does not mean that asthma was the cause. All you may be doing is masking the real cause of your breathing problems and placing yourself at risk of long-term harm.
Asthma Attack: Steps to Take in the Moment
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fergeson JE, Patel SS, Lockey RF.Acute asthma, prognosis, and treatment.J Allergy Clin Immunol.2017;139(2):438-47. doi:10.1016/j.jaci.2016.06.054Lee AS, Lee JS, He Z, Ryu JH.Reflux-aspiration in chronic lung disease.Ann Am Thorac Soc.2020;17(2):155-64. doi:10.1513/AnnalsATS.201906-427CMEInamdar AA, Inamdar AC.Heart failure: Diagnosis, management and utilization.J Clin Med. 2016;5(7):62. doi:10.3390/jcm5070062Riario Sforza GG, Marinou A.Hypersensitivity pneumonitis: a complex lung disease.Clin Mol Allergy. 2017;15:6. doi:10.1186/s12948-017-0062-7Spangolo P, Rossi G, Trisolini R, et al.Pulmonary sarcoidosis.Lancet Respir Med. 2018 May;6(5):389-402. doi:10.1016/S2213-2600(18)30064-XJunker K.Pathology of tracheal tumors.Thorac Surg Clin.2014;24(1):7-11. doi:10.1016/j.thorsurg.2013.09.008Morici B.Diagnosis and management of acute pulmonary embolism.JAAPA.2014;27(4):18-22. doi:10.1097/01.JAA.0000444729.09046.09Chhabra SK.Clinical application of spirometry in asthma: Why, when and how often?.Lung India. 2015;32(6):635-7. doi:10.4103/0970-2113.168139Kitaguchi Y, Fujimoto K, Komatsu Y, Hanaoka M, Honda T, Kubo K.Additive efficacy of short-acting bronchodilators on dynamic hyperinflation and exercise tolerance in stable COPD patients treated with long-acting bronchodilators.Respir Med. 2013;107(3):394-400. doi:10.1016/j.rmed.2012.11.013Liang TZ, Chao JH.Inhaled corticosteroids. In: StatPearls.National Heart, Lung, and Blood Institute.Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma.Kirkland SW, Vandenberghe C, Voaklander B, Nikel T, Campbell S, Rowe BH.Combined inhaled beta-agonist and anticholinergic agents for emergency management in adults with asthma.Cochrane Database Syst Rev. 2017;1(1):CD001284. doi:10.1002/14651858.CD001284.pub2Cheyne L, Irvin-Sellers MJ, White J.Tiotropium versus ipratropium bromide for chronic obstructive pulmonary disease.Cochrane Database Syst Rev.2015;(9):CD009552. doi:10.1002/14651858.CD009552.pub3Montuschi P.Role of Leukotrienes and leukotriene modifiers in asthma.Pharmaceuticals (Basel).2010;3(6):1792-1811. doi:10.3390/ph3061792
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fergeson JE, Patel SS, Lockey RF.Acute asthma, prognosis, and treatment.J Allergy Clin Immunol.2017;139(2):438-47. doi:10.1016/j.jaci.2016.06.054Lee AS, Lee JS, He Z, Ryu JH.Reflux-aspiration in chronic lung disease.Ann Am Thorac Soc.2020;17(2):155-64. doi:10.1513/AnnalsATS.201906-427CMEInamdar AA, Inamdar AC.Heart failure: Diagnosis, management and utilization.J Clin Med. 2016;5(7):62. doi:10.3390/jcm5070062Riario Sforza GG, Marinou A.Hypersensitivity pneumonitis: a complex lung disease.Clin Mol Allergy. 2017;15:6. doi:10.1186/s12948-017-0062-7Spangolo P, Rossi G, Trisolini R, et al.Pulmonary sarcoidosis.Lancet Respir Med. 2018 May;6(5):389-402. doi:10.1016/S2213-2600(18)30064-XJunker K.Pathology of tracheal tumors.Thorac Surg Clin.2014;24(1):7-11. doi:10.1016/j.thorsurg.2013.09.008Morici B.Diagnosis and management of acute pulmonary embolism.JAAPA.2014;27(4):18-22. doi:10.1097/01.JAA.0000444729.09046.09Chhabra SK.Clinical application of spirometry in asthma: Why, when and how often?.Lung India. 2015;32(6):635-7. doi:10.4103/0970-2113.168139Kitaguchi Y, Fujimoto K, Komatsu Y, Hanaoka M, Honda T, Kubo K.Additive efficacy of short-acting bronchodilators on dynamic hyperinflation and exercise tolerance in stable COPD patients treated with long-acting bronchodilators.Respir Med. 2013;107(3):394-400. doi:10.1016/j.rmed.2012.11.013Liang TZ, Chao JH.Inhaled corticosteroids. In: StatPearls.National Heart, Lung, and Blood Institute.Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma.Kirkland SW, Vandenberghe C, Voaklander B, Nikel T, Campbell S, Rowe BH.Combined inhaled beta-agonist and anticholinergic agents for emergency management in adults with asthma.Cochrane Database Syst Rev. 2017;1(1):CD001284. doi:10.1002/14651858.CD001284.pub2Cheyne L, Irvin-Sellers MJ, White J.Tiotropium versus ipratropium bromide for chronic obstructive pulmonary disease.Cochrane Database Syst Rev.2015;(9):CD009552. doi:10.1002/14651858.CD009552.pub3Montuschi P.Role of Leukotrienes and leukotriene modifiers in asthma.Pharmaceuticals (Basel).2010;3(6):1792-1811. doi:10.3390/ph3061792
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fergeson JE, Patel SS, Lockey RF.Acute asthma, prognosis, and treatment.J Allergy Clin Immunol.2017;139(2):438-47. doi:10.1016/j.jaci.2016.06.054Lee AS, Lee JS, He Z, Ryu JH.Reflux-aspiration in chronic lung disease.Ann Am Thorac Soc.2020;17(2):155-64. doi:10.1513/AnnalsATS.201906-427CMEInamdar AA, Inamdar AC.Heart failure: Diagnosis, management and utilization.J Clin Med. 2016;5(7):62. doi:10.3390/jcm5070062Riario Sforza GG, Marinou A.Hypersensitivity pneumonitis: a complex lung disease.Clin Mol Allergy. 2017;15:6. doi:10.1186/s12948-017-0062-7Spangolo P, Rossi G, Trisolini R, et al.Pulmonary sarcoidosis.Lancet Respir Med. 2018 May;6(5):389-402. doi:10.1016/S2213-2600(18)30064-XJunker K.Pathology of tracheal tumors.Thorac Surg Clin.2014;24(1):7-11. doi:10.1016/j.thorsurg.2013.09.008Morici B.Diagnosis and management of acute pulmonary embolism.JAAPA.2014;27(4):18-22. doi:10.1097/01.JAA.0000444729.09046.09Chhabra SK.Clinical application of spirometry in asthma: Why, when and how often?.Lung India. 2015;32(6):635-7. doi:10.4103/0970-2113.168139Kitaguchi Y, Fujimoto K, Komatsu Y, Hanaoka M, Honda T, Kubo K.Additive efficacy of short-acting bronchodilators on dynamic hyperinflation and exercise tolerance in stable COPD patients treated with long-acting bronchodilators.Respir Med. 2013;107(3):394-400. doi:10.1016/j.rmed.2012.11.013Liang TZ, Chao JH.Inhaled corticosteroids. In: StatPearls.National Heart, Lung, and Blood Institute.Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma.Kirkland SW, Vandenberghe C, Voaklander B, Nikel T, Campbell S, Rowe BH.Combined inhaled beta-agonist and anticholinergic agents for emergency management in adults with asthma.Cochrane Database Syst Rev. 2017;1(1):CD001284. doi:10.1002/14651858.CD001284.pub2Cheyne L, Irvin-Sellers MJ, White J.Tiotropium versus ipratropium bromide for chronic obstructive pulmonary disease.Cochrane Database Syst Rev.2015;(9):CD009552. doi:10.1002/14651858.CD009552.pub3Montuschi P.Role of Leukotrienes and leukotriene modifiers in asthma.Pharmaceuticals (Basel).2010;3(6):1792-1811. doi:10.3390/ph3061792
Fergeson JE, Patel SS, Lockey RF.Acute asthma, prognosis, and treatment.J Allergy Clin Immunol.2017;139(2):438-47. doi:10.1016/j.jaci.2016.06.054
Lee AS, Lee JS, He Z, Ryu JH.Reflux-aspiration in chronic lung disease.Ann Am Thorac Soc.2020;17(2):155-64. doi:10.1513/AnnalsATS.201906-427CME
Inamdar AA, Inamdar AC.Heart failure: Diagnosis, management and utilization.J Clin Med. 2016;5(7):62. doi:10.3390/jcm5070062
Riario Sforza GG, Marinou A.Hypersensitivity pneumonitis: a complex lung disease.Clin Mol Allergy. 2017;15:6. doi:10.1186/s12948-017-0062-7
Spangolo P, Rossi G, Trisolini R, et al.Pulmonary sarcoidosis.Lancet Respir Med. 2018 May;6(5):389-402. doi:10.1016/S2213-2600(18)30064-X
Junker K.Pathology of tracheal tumors.Thorac Surg Clin.2014;24(1):7-11. doi:10.1016/j.thorsurg.2013.09.008
Morici B.Diagnosis and management of acute pulmonary embolism.JAAPA.2014;27(4):18-22. doi:10.1097/01.JAA.0000444729.09046.09
Chhabra SK.Clinical application of spirometry in asthma: Why, when and how often?.Lung India. 2015;32(6):635-7. doi:10.4103/0970-2113.168139
Kitaguchi Y, Fujimoto K, Komatsu Y, Hanaoka M, Honda T, Kubo K.Additive efficacy of short-acting bronchodilators on dynamic hyperinflation and exercise tolerance in stable COPD patients treated with long-acting bronchodilators.Respir Med. 2013;107(3):394-400. doi:10.1016/j.rmed.2012.11.013
Liang TZ, Chao JH.Inhaled corticosteroids. In: StatPearls.
National Heart, Lung, and Blood Institute.Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma.
Kirkland SW, Vandenberghe C, Voaklander B, Nikel T, Campbell S, Rowe BH.Combined inhaled beta-agonist and anticholinergic agents for emergency management in adults with asthma.Cochrane Database Syst Rev. 2017;1(1):CD001284. doi:10.1002/14651858.CD001284.pub2
Cheyne L, Irvin-Sellers MJ, White J.Tiotropium versus ipratropium bromide for chronic obstructive pulmonary disease.Cochrane Database Syst Rev.2015;(9):CD009552. doi:10.1002/14651858.CD009552.pub3
Montuschi P.Role of Leukotrienes and leukotriene modifiers in asthma.Pharmaceuticals (Basel).2010;3(6):1792-1811. doi:10.3390/ph3061792
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