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The Dyspneic Athlete
The Dyspneic Athlete
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Pdf Summary
The article "Field Management of Sports Injuries" by David Krey and Thomas Best, published online in 2014, discusses common breathing issues in athletes, particularly focusing on exercise-induced bronchoconstriction (EIB) and paradoxic vocal fold movement disorder (PVFMD), often referred to as vocal cord dysfunction (VCD). The misdiagnosis of PVFMD as EIB can lead to unnecessary treatments, which highlights the importance of accurate diagnosis and appropriate management to avoid unnecessary healthcare costs.<br /><br />EIB is more prevalent among athletes than the general population, particularly in cold weather sports and those involving high ventilatory demands, due to environmental triggers like chlorine, chemicals in ice rinks, etc. The condition involves acute bronchoconstriction provoked by exercise, with symptoms including cough, wheezing, chest tightness, and fatigue. Diagnosing EIB accurately is challenging as symptoms overlap with other conditions, necessitating objective testing such as spirometry and bronchoprovocation tests. Treatment generally involves short-acting beta agonists, and in some cases, inhaled corticosteroids or leukotriene modifiers.<br /><br />PVFMD, often confused with asthma, is characterized by intermittent breathing difficulties due to abnormal vocal cord movements during exercise. It is underdiagnosed, leading to increased healthcare costs. Treatment prioritizes behavioral therapy with speech-language pathologists, supported by addressing comorbid conditions such as anxiety and reflux.<br /><br />The authors argue for a comprehensive differential diagnosis when athletes present with dyspnea, considering other causes such as cardiac issues, pulmonary embolus, and pneumomediastinum. Accurate diagnosis begins with a thorough history and physical exam and may require multidisciplinary management. The review emphasizes understanding medications and testing regulations related to respiratory issues in athletes.
Meta Tag
Edition
3rd Edition
Related Case
3rd Edition, CASE 33
Topic
Lung
Keywords
3rd Edition, CASE 33
3rd Edition
Lung
exercise-induced bronchoconstriction
paradoxic vocal fold movement disorder
vocal cord dysfunction
athletes
misdiagnosis
breathing issues
diagnosis
treatment
spirometry
behavioral therapy
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