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Asthma

Daughter has excercise induced asthma?

11/19/2008

Question:

2 years ago,my daughter,who was 11 at the time played basketball.She had always been one of the best players on the team,but when they moved to a full court game in the 5th grade,she complained of difficulty breathing and chest pain and became afraid to play,thinking she was going to faint or worse,die. We took her to the Dr.,they did an EKG which was normal,and never really gave us a diagnosis. She finished out the season,playing only a cameo role,removing herself when she became uncomfortable and dizzy. Do you think she displays symptoms of excercise induced asthma? Thanks,

Answer:

The most common reasons for difficulty breathing/chest discomfort during exercise in otherwise healthy children include asthma, deconditioning (being out of shape), and a problem called vocal cord dysfunction (in which the vocal cords close together, rather than stay wide open, during breathing leading to a sensation of inability to breath.)  Less commonly, stomach acid reflux during exertion can cause some of these symptoms.  Very rarely, the symptoms are related to a cardiac/heart issue.

Given the degree to which this problem is impairing your daughter (it's had a major impact on her ability - or at least willingness - to be fully active in sports), she clearly should have further evaluation to sort out what the trouble is.  If it's asthma, medications can cause tremendous improvement.  If it's a vocal cord issue, learning how to breath in a way that keeps the vocal cords relaxed fixes the problem.  Based on the details you provide, these two diagnoses sound like the issues that should be evaluated first.

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Response by:

Elizabeth D Allen, MD Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University