Asthma causes your airways to tighten, become inflamed (swell), and become overreactive. This makes it hard to breathe. It’s a common chronic (long-term) disease that affects more than 27 million people in the United States.
Common symptoms of asthma include shortness of breath, wheezing, and coughing. To make a diagnosis, your doctor will look at your medical history and perform a physical exam. They may also do lung function tests.
Other respiratory illnesses can have similar symptoms to asthma but require different treatment. That’s why it’s important to get an accurate diagnosis.
One study showed that one out of three people diagnosed with asthma didn’t actually have the condition.1
What Conditions Are Similar to Asthma?
Here are some other health conditions that can have symptoms similar to asthma:
- Acid reflux (gastrointestinal reflux disease or GERD)
- Bronchopulmonary dysplasia
- Chronic obstructive pulmonary disease (COPD – emphysema or chronic bronchitis)
- Cystic fibrosis
- Enlarged lymph nodes
- Heart attack
- Heart failure
- Hiatal hernia
- Lung cancer (tumors)
- Parasitic infections
- Pulmonary edema
- Pulmonary embolism
- Recurrent cough not due to asthma
- Sinus infections
- Transient wheeze not due to asthma
- Upper airway obstruction (such as tracheal stenosis, benign airway tumor, malignant tumor, goiter, tracheomalacia, right-sided aortic arch, or other upper airway obstruction)
- Viral infections
- Vocal cord dysfunction or paralysis
Getting the right diagnosis can mean better quality of life. For some more serious conditions, it can be the difference between life and death. These other conditions may need other specific treatments instead of typical asthma medicines.
When asthma doesn’t respond to asthma medicine, some doctors prescribe oral corticosteroids. One example is prednisone. This medicine is only for short-term use. Prolonged use of oral corticosteroids due to misdiagnosis may have harmful side effects. This is another reason why a correct diagnosis is important.
How Do I Know If I Have Been Misdiagnosed With Asthma?
If you have been following an asthma treatment plan but it isn’t helping, talk with your doctor. They may have you do a test called a methacholine [meth-uh-KOH-leen] challenge.
Methacholine is a type of drug that will tighten your airways at a lower dose if you have asthma. Your airways will tighten at a higher dose if you do not have asthma. During this test, your doctor will have you breathe in increasing doses of methacholine at scheduled intervals over time. Then they will do a spirometry test after each dose to see if your lung function changes.
If your lung function goes down a lot during the test, that means you have asthma. People without asthma should be able to go through the entire test without a major drop in their lung function.
If your lungs do not react to lower doses of methacholine, you may have another condition that has similar symptoms to asthma.
Medical Review: July 2022 by John James, MD
1. Shawn D. Aaron, Katherine L. Vandemheen, J. Mark FitzGerald, Martha Ainslie, Samir Gupta, Catherine Lemière, Stephen K. Field, R. Andrew McIvor, Paul Hernandez, Irvin Mayers, Sunita Mulpuru, Gonzalo G. Alvarez, Smita Pakhale, Ranjeeta Mallick, Louis-Philippe Boulet. Revaluation of Diagnosis in Adults With Physician-Diagnosed Asthma. JAMA. 2017;317(3):269–279. doi:10.1001/jama.2016.19627.