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Do I have a mild form of asthma?

Expert Panel Question???

“When I run my chest burns like crazy. After a while I start to get light headed and dizzy. Do I have a mild form of asthma?”

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In addressing chest symptoms whether related to activity or not it is helpful to think of the 4 body areas in the chest that these symptoms may be coming from: the heart, the lungs, the esophagus or the chest wall. Of these four, a problem with the heart raises the most concern and should be addressed first (for obvious reasons). This is followed by the lungs, the esophagus and then the chest wall.

Any chest symptom associated with activity and especially those that include light headedness and dizziness as the run continues necessitates at least a basic cardiac evaluation i.e. a thorough history including family history, a listen to the heart with a stethoscope and an office EKG (electrocardiogram). If there is any concern based on these tests, additional tests may be needed. Once you are reassured that your heart is ok we move on to evaluating the lungs.

Exercise induced asthma (formally known as exercise induced bronchospam or EIB) is not uncommon in runners – up to 30% in some studies – and could explain your symptoms. EIB is defined as a reduction of 15% in your normal lung function at rest compared to after you exercise. People with exercise induced asthma may or may not have underlying asthma but people with asthma almost always have exercise induced symptoms.

Symptoms may include wheezing during activity, a feeling like you can not get a deep enough breath while running (known as air hunger) or, more commonly, coughing that persists long after exercise. Symptoms are made worse in dry climates such as we have in Utah, higher altitude, more intense running and exercising indoors. It is believed that the dry air reaching our lungs when we are breathing hard through our mouth dries out and irritates the lining of our bronchial tubes causing them to spasm and narrow, thus making it harder to breathe and even wheeze.

If this also results in a feeling of air hunger there may be a tendency for you to hyperventilate (breathe too fast) which can then lead to light headedness and dizziness. EIB can be tested for by doing before and after exercise lung function tests.

If your test indicates that you have EIB, several different prescription medications are available to treat the symptoms. Regardless of the cause, you need to be evaluated by a health care provider with experience in athletic health issues.

by Steve Scharmann – MD, Sports Medicine, Family Practice | Competitive Runner/Triathlete

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This entry was posted on Thursday, May 20th, 2010 at 8:26 pm and is filed under Expert Answers, Injuries and Pain, Sports Medicine. You can follow any responses to this entry through the RSS 2.0 feed.

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