SC di Pneumologia, SS di Allergologia, Ospedale Infantile “Regina Margherita”, Torino
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Key words: Exercise-induced symptoms, Dyspnoea, Asthma, Physical conditioning
Unexplained limitation to exercise is a common clinical problem in children and adolescents. Exercise-induced asthma (EIA) is the most common manifestation. Bronchodilators and other medications have been used in prevention and treatment of EIA and should allow the majority of patients with asthma to perform regular physical activity. Although asthma is the most common cause, dyspnoea on exertion can be a result of other causes. Restrictive thoracic cage abnormalities (scoliosis and pectus deformities) can produce dyspnoea only on exertion. Vocal cord dysfunction syndrome or the less common exercise-induced laryngomalacia and tracheobronchomalacia are often attributed to asthma. Most common is dyspnoea associated with normal physiologic exercise limitation but other causes can include exercise-induced hyperventilation, supraventricular tachycardia and other cardiac abnormalities. Spirometry, and exercise testing with cardiopulmonary monitoring, including gas exchange, provide useful data to sort out the various causes and avoid inappropriate treatments.
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