Asthma Can Be Fatal: Please Go for Annual Check-ups

An unusual case

I read a disturbing story in Newsday last week about a teenage boy playing basketball in Long Beach, N.Y. (my hometown) who collapsed and died while playing a basketball game with his friends. The details are scant at this time as to the exact cause of death, but he did have a known history of asthma. The article said that he had been diagnosed with asthma in the past, but wasn’t on any current medications because he hadn’t had an asthma attack in a while. It is unusual for a teenager or adult to get a sudden asthma attack without some prodrome (early warning signs) such as shortness of breath, wheezing, or constant coughing, unless it’s from a food allergy, which triggers anaphylaxis (the most dangerous type of food allergic reaction).

Keep your inhaler fresh and ready

As a NYC asthma doctor, my main concern in this case is to remind all patients with a history of asthma to carry an updated rescue inhaler, like Ventolin or ProAir, to have on hand if you develop any acute symptoms that may be related to asthma. I often find a patient who is doing well is doing well has an inhaler that is expired. Asthma can be brought on by many factors: cold air (like the frigid weather we have now), exercise (it may happen a few minutes or even an hour after finishing a vigorous workout), emotions (nothing like a nasty argument to cause tension and bronchospasm), and of course, air-borne allergies like cat or dog dander, dust, mold or pollen (in the spring or fall). Periodic checkups to measure your breathing status with a peak flow meter or a spirometry (lung function test in the office) is good way to keep tabs on how strong your breathing really is.

Rethinking a diagnosis

The other important point in cases like this is for the physician who takes care of any patient diagnosed with asthma to occasionally re-think the diagnosis. I discuss this in my book, Dr. Dean Mitchell’s Allergy and Asthma Solution (Marlowe 2006) that other conditions can masquerade as asthma, and require a totally different treatment. In young teens or adults, a condition called Hypertrophic Cardiomyopathy can exist that can cause episodes of shortness of breath, because the heart is too thick and can cause irregular heartbeats and rhythms. This can lead to fatal arrhythmias (irregular heart rhythms). A doctor needs a high suspicion because a heart murmur is not always heard, and an ECHO cardiogram is needed to help make the diagnosis. As a New York Asthma Specialist, I use a detailed history to guide me whether a person’s asthma is authentic. I also find allergy tests help support the diagnosis of asthma, since 70% of asthmatics tend to have a positive allergy test.

The key is with a proper diagnosis and proper education on which inhalers to use and when to use them, any patient with asthma should feel confident to reverse and control his symptoms.

Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island

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