Atypical Asthma with Chief Complaint of Palpitations: Twelve Cases Analysis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

Department of Respiratory Medicine, Changhai Hospital Affiliated to The Second Military Medical University, Shanghai, 200433, China;

Corresponding author：

Keywords：

Asthma; Palpatation; Diagnosis; Fractional exhaled nitric oxide; Lung function

DOI：

10.7507/1671-6205.2014029

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Objective To explore the clinical features of atypical bronchial asthma with chief complaint of palpitations. Methods Twelve cases with unexplained palpitations diagnosed by asthma were analyzed retrospectively. Results The patients were diagnosed with asthma through bronchodilation test,skin prick tests,fractional exhaled nitric oxide (FeNO) and diagnostic treatment.The ratio of male to female cases was 1:5. The ventilation lung function of all patients was in normal range. The median time of misdiagnosis was 13.5(3-120) months. 41.6% of cases had dust mite positive skin prick test. The median value of FeNO was 32.75(18-54) ppb. The symptoms of all patients were relieved completely after standard treatment. Conclusion Palpatation may be a specific presentation of asthma characterized with eosinophilic airway inflammation which may be misdiagnosed as other diseases for a long time,especially in elder women. To improve the knowledge of this kind of atypical asthma,detailed medical history, experimental examinations and diagnostic treatment response are important to confirm the diagnosis in time.

Citation： Zhang Jingxi, Han Yiping, Bai Chong, Li Qiang. Atypical Asthma with Chief Complaint of Palpitations: Twelve Cases Analysis. Chinese Journal of Respiratory and Critical Care Medicine, 2013, 12(2): 112-115. doi: 10.7507/1671-6205.2014029 Copy

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1. 吴永红,刘春涛.以胸痛为主诉的支气管哮喘26例临床分析.中国呼吸与危重监护杂志,2007,6: 12-14.
2. 夏迎雪,薛克栋,张建.以胸痛为主要表现的支气管哮喘.中华结核和呼吸杂志,2007,30: 65.
3. Global Strategy for Asthma Management and Prevention,Global Initiative for Asthma(GINA)2011.Available from:http://ginasthma.org.
4. Shen H,Hua W,Wang P,et al.A new phenotype of asthma: chest tightness as the sole presenting manifestation.Ann Allergy Asthma Immunol,2013,111:226-227.
5. Foschino Barbaro MP,Costa VR,Resta O,et al.Menopausal asthma: a new biological phenotype?Allergy,2010,65:1306-1312.
6. 王晓芝,赵铭山.夜间哮喘发生机制的研究.中华结核和呼吸杂志,2000,23: 576.
7. Skovsted GF,Pedersen AF,Larsen R,et al.Rapid functional upregulation of vasocontractile endothelin ETB receptors in rat coronary arteries.Life Sci,2012,91:593-599.
8. Romero KM,Robinson CL,Baumann LM,et al.PURA Study Investigators.Role of exhaled nitric oxide as a predictor of atopy.Respir Res,2013,14:48.
9. van den Berge M,Heijink HI,van Oosterhout AJ,et al.The role of female sex hormones in the development and severity of allergic and non-allergic asthma.Clin Exp Allergy,2009,39:1477-1481.
10. 中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗和管理方案).中华结核和呼吸杂志,2008,31: 177-185.

Chinese Journal of Respiratory and Critical Care Medicine

Atypical Asthma with Chief Complaint of Palpitations: Twelve Cases Analysis

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