Stephen J. Schueler, M.D.

Wheezing due to Asthma Evaluation

The evaluation of asthma begins with a complete history and physical examination.

Physical findings in those with asthma may include:

The diagnosis of asthma is usually confirmed through testing.

Tests for asthma may include:

Wheezing due to Asthma Mild Asthma

Characteristics of mild asthma include:

  • Wheezing is mild
  • Attacks last less than 1 hour
  • Attacks occur less than 3 times a week
  • Nighttime attacks occur less than two times per month
  • No symptoms are present between attacks
  • During exercise, symptoms are present for less than one-half hour

Wheezing due to Asthma Moderate Asthma

Characteristics of moderate asthma include:

  • Wheezing is moderate to severe
  • Attacks may last several days
  • Attacks occur more than 3 times per week
  • Nighttime symptoms occur more than twice a month
  • Attacks are prolonged during exercise
  • Emergency care is required occasionally

Wheezing due to Asthma Severe Asthma

Characteristics of severe asthma include:

  • Wheezing is severe during attacks
  • Wheezing is present continuously
  • Attacks limit normal daily activity
  • Attacks occur more than 4 times per week
  • Nighttime symptoms occur more than twice a week
  • Emergency care is required frequently
  • Hospitalization may be required

Wheezing due to Asthma Testing Peak Flow

The peak expiratory flow rate or PEFR is used to assess the severity of wheezing in those who have asthma. PEFR measures how quickly a person can exhale air from the lungs. You need to have peak flow meter device if you want to measure your PEFR.

It is important to learn the proper technique for using your peak flow meter. Younger children can have trouble with this, but most children over 5 years of age can learn how to use the peak flow meter correctly.

Important values for you to know:

  • Your personal best PEFR:
    • This is the highest PEFR you can blow when you don't have asthma symptoms.
    • Make this determination when you feel good.
  • Your peak flow zone:
    • Make this determination only when you have asthma symptoms
    • Your PEFR zone is measured by how close your current PEFR is to your personal best PEFR.

PEFR zones:
  • Green Zone:
    • Your current PEFR is 80-100% of personal best PEFR
    • This is a mild asthma attack
    • You should have a treatment strategy in place for when you are in the green zone
  • Yellow Zone:
    • Your current PEFR is 50-80% of personal best PEFR
    • This is a moderate asthma attack
    • You should have a treatment strategy in place for when you are in the yellow zone
  • Red Zone:
    • Your current PEFR is less than 50% of personal best PEFR
    • This is a severe asthma attack and will need to see a doctor now.
    • You should have a treatment strategy in place for when you are in the red zone

Continue to Wheezing due to Asthma Treatment

Last Updated: Nov 17, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Wheezing due to Asthma References
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  5. Rees J. ABC of asthma. Prevalence. BMJ. 2005 Aug 20;331(7514):443-5. [16110074]
  6. Vallance G, Thomson NC. Asthma: ten myths debunked. Practitioner. 2004 Nov;248(1664):844-7. [15543882]
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