What can be mistaken for asthma?

Asthma is an inflammatory health condition where your airways are overreactive and often become inflamed in response to certain triggers. It is a common condition that may affect you throughout your life and can cause coughing, wheezing, and shortness of breath.

A variety of other respiratory health conditions can cause the same symptoms. For this reason, they may be mistakenly diagnosed as asthma. These include chronic obstructive pulmonary disease (COPD) and allergic rhinitis.

Different conditions need different treatments, so getting the right diagnosis is important.

COPD

According to the Asthma and Allergy Foundation of America (AAFA), around 1 in 3 people who receive asthma diagnoses do not actually have the condition but instead have a condition that causes similar symptoms.

The term “COPD” refers to a group of respiratory conditions that cause thickening of and damage to your airway wall. As a result, you may experience trouble breathing, a persistent cough, and wheezing.

While asthma is an inflammatory health condition that’s genetic in origin and affects people of all ages, COPD typically:

• develops over your lifetime
• is linked with smoking and smoke exposure
• occurs in people primarily over age 40 years

Plus, if you have COPD, your breathing will never feel completely right and will get worse over time. People with asthma, on the other hand, will experience periods where their breathing is unaffected by symptoms.

GERD

Gastrointestinal reflux disease (GERD) is a health condition in which the acid from your stomach leaks upward into your esophagus (the tube that food travels down). This causes symptoms of heartburn but can trigger symptoms of asthma, like the tightening of your airways.

If acid reflux continues without treatment, it can cause further damage to your airways, which leads to difficulty breathing and a persistent cough.

Allergic rhinitis

Allergic rhinitis, or seasonal allergies like hay fever, can cause the same symptoms as asthma, such as wheezing and restricted breathing. It is a common condition that affects a varying proportion of people worldwide, depending on factors like climate and allergens present.

Allergic rhinitis and asthma are both more common in children. It’s also common to have both conditions at the same time.

Allergic rhinitis may also be underdiagnosed in adults, perhaps due to it being mistaken for similar conditions like asthma, and there is a lack of large population studies to know the true prevalence.

Heart failure

If you have heart failure, you may experience shortness of breath, coughing, or wheezing. These symptoms are known as cardiac asthma, and this condition is often mistaken for typical asthma. It can feel exactly like asthma, but heart failure is not caused by an irritated airway.

Cardiac asthma occurs in people with heart failure as the heart struggles to pump the blood around the lungs well enough. This stops it from oxygenating, causing breathlessness.

The treatment for cardiac asthma differs from the treatment for bronchial asthma.

How to tell if it’s asthma

Some certain factors and symptoms are characteristic of asthma. These include:

• dry cough
• worsening symptoms during exercise
• difficulty breathing
• wheezing
• tightness in your chest
• worsening symptoms at night
• difficulty drawing a full breath

Most children with asthma will show symptoms before they turn 5 years old. You should look out for a nagging cough that lingers for days or weeks, as well as episodes where they have difficulty breathing.

Doctors will typically diagnose asthma based on your symptoms, and they may do a test called spirometry to measure your lung function as well.

Treatments

The treatments for conditions that affect your breathing may be different from those for asthma.

Asthma

For asthma, doctors might prescribe different medications, like inhaled bronchodilators and inhaled corticosteroids. These can be short-acting for use during an asthma attack or long-acting to have effects over a longer period.

Some short-acting bronchodilators include albuterol (Proair Hfa) and levalbuterol (Xopenex). Longer-acting ones include formoterol (Performist).

Inhaled corticosteroids for asthma include fluticasone (Flovent). Sometimes, bronchodilators are combined with corticosteroids, such as fluticasone salmeterol (Advair).

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COPD

There is no cure for COPD, and treatment for managing symptoms will be different for different individuals.

Treatments often help to:

• manage symptoms
• slow symptom and disease progression
• improve your ability to keep moving
• reduce the risk of a symptom flare-up

Options that a doctor may recommend include:

• quitting smoking, if applicable
• taking bronchodilator medications like Performist
• taking inhaled corticosteroids like Advair
• undergoing exercises to increase your ease of breathing (pulmonary rehabilitation)
• receiving supplementary oxygen
• having surgery

GERD

If you regularly experience GERD or heartburn, a doctor may recommend the following treatment and lifestyle changes:

• losing weight, if needed
• quitting smoking, if applicable
• reducing the fat content in your diet
• taking antacid medications (Tums)
• taking H2 blocker medications like cimetidine (Tagamet) or famotidine (Pepcid)
• taking proton pump inhibitors like lansoprazole (Prevacid) or omeprazole (Prilosec)

Allergic rhinitis

The most effective treatment for allergic rhinitis is to identify what triggers your symptoms. By knowing what sets off your symptoms, you can do your best to avoid those triggers.

Medications for managing symptoms that develop include:

• antihistamines such as diphenhydramine (Benadryl)
• nasal saline irrigation to cleanse your nasal passages
• corticosteroids, often as nasal sprays such as beclomethasone (Beconase)

Heart failure

There is no cure for heart failure, but a doctor will likely recommend a combination of lifestyle changes and medications to help you live a longer and active life.

These lifestyle changes may include:

• avoiding alcohol, if you drink
• quitting smoking, if you smoke
• lowering your intake of salt
• maintaining a healthy weight
• eating a diet low in saturated fat
• managing your stress
• maintaining a good quality sleep schedule

Medications that a doctor may recommend include:

• diuretics like furosemide (Lasix)
• ACE inhibitors like trandolapril (Mavik)
• beta-blockers like acebutolol (Sectral)

Summary

Asthma causes symptoms that affect your respiratory system and your breathing. You might notice wheezing and shortness of breath.

But other health conditions may cause similar symptoms, including COPD and GERD. These often have different causes and may have other, slightly different symptoms to look out for.

Asthma is often treated with inhaled medications. COPD is treated similarly, but other conditions might use medications that treat the root cause rather than the symptoms. A doctor will be able to diagnose your condition and work with you to treat it accordingly.

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