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Table 12 Criteria to Distinguish Asthma from Other Wheezing Disorders*

	Asthma	VCDS	Tracheo- bronchial Obstruction	COPD	Bronchio-litis Obliterans	Cardiogenic Pulmonary Edema
I. History
Seasonal	+	-	-	-	-	-
Labile/abrupt	+++	++or+++	-	-	-	+
A.M. dipping	+	-	-	Rare	-	+
Sinusitis	++	-	-	-	-	-
Exercise induced	++or+++	+	+	-/Rare	-	±
Responds to therapy	++or+++	±	-	+	±	-
Post URI	++	-	-	+	+	-
Heavy tobacco use	Rare	Rare	+, with cancer	+++	Unrelated	+, with ASHD
II. Physical
Expiratory wheezes	++or+++	±	+	++	±	±
Volume lung	or	Normal	Normal, +	or		Normal
Breath sounds	Normal,	Normal				Nomal, or (Effusions)
Pulsus paradoxus	+, when severe	-	-	-	-	-
Inspiratory wheezes	+	+++	+	-	± (Crackles)	Crackles & Wheezes
III. Pulmonary Function Tests, (PFT’s)
Expiratory flow		±
Inspiratory flow	Nomal, or				Normal	Normal
Volumes		Normal	Nomal, or		or
Reversible	++or+++	-	-	±	-	±
DLCO	Nomal, or	Normal	Nomal, or	or		Nomal, or
IV. Chest X-ray
Volumes		Normal	Normalor			Normal
Infiltrates	Occasionally	-	Occasionally	-	Occasionally (BOOP)	Usual
Symmetry	Usually (mucus plugs may cause atelectasis)	Normal	Asymmetry (get inspiratory/ expiratory views)	Normal	Usual	Usual
V. Arterial Blood Gases (ABGs)
O2		Normal	Nomal, or
CO2				Normal or		Variable
VI. Others
EOS	±	Normal	Normal	Normal	Normal	Normal
IgE	±	Normal	Normal	Normal	Normal	Normal
Hgb/Hct	Normal	Normal	Normal	Normal or	Normal	Normal
ECG	NST	NST	Normal	RVE/RVH	Normal or RVE/RVH	LVE/RVH
*Abbreviations ASHD=arteriosclerotic heart disease; BOOP=bronchiolitis obliterans with organizing pneumonia; COPD= chronic obstructive pulmonary disease; DLCO=diffusion test; ECG=echocardiogram; EOS=eosinophils; Hct=hematocrit Hgb=hemoglobin; lgE=immunoglobin E; LVE= left ventricular enlargement; NST= non-significant T-wave; RVE=right ventricular enlargement; RVH=right ventricular hypertrophy; URI=upper respiratory tract infection; VCDS=vocal cord dysfunction syndrome

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