Figure 1. Algorithm for the Diagnosis, Treatment,
and Differential Diagnosis of EIB
Symptoms
suggestive of EIB
Differential Diagnosis for EIB
• Exercise-induced laryngeal dysfunction (e.g., VCD) (SS11)
- Flow volume loop
- Exercise Rhinolaryngoscopy
• Exercise-induced hyperventilation / dyspnea – healthy
obese (SS12)
- Cardiopulmonary exercise testing
• Obstructive/Restrictive lung disease (SS13)
- Imaging, Full pulmonary function testing
d
• Obesity, Skeletal Defects, Diaphragmatic Paralysis,
Interstitial Fibrosis (SS13)
- Full pulmonary function testing
d
, respiratory muscle
strength tests
• Exercise-induced anaphylaxis (SS14)
- Allergy skin testing, identify possible dietary triggers
• Breathlessness with exercise due to possible cardiovascular,
pulmonary or gastrointestinal mechanisms. (SS15)
- Echocardiograph, EKG, Holter monitor
- Cardiopulmonary exercise testing
• Exercise-induced dyspnea – age appropriate (SS15)
- Cardiopulmonary exercise testing
• Exertional GERD
• Mitochondrial enzyme deficiency
• Psychological (SS16)
FEV1 <70%
Diagnostic Treatment
Spirometry
No β
2
agonist
reversibility
Reversible airway obstruction
consistent with asthma and
high risk of EIB
β
2
agonist
reversibility
a
Treatment
