What are the clinical signs of asthma?

The clinical signs of asthma on examination are:

  • A generalised, expiratory wheeze, especially on forced expiration.
  • The chest may appear full (hyperexpanded due to air trapping) with prolonged expiration.
  • There may be lower chest wall indrawing.
  • The use of muscles in the abdomen or neck during expiration suggests severe airways obstruction.
  • Cyanosis, drowsiness or panic are signs of respiratory failure.
  • Usually there is no fever.
  • Long standing, poorly controlled asthma may result in chest deformity and poor growth.
  • Between acute attacks the chest examination is usually normal.

The sudden onset of wheezing during play in a well child with no history of asthma suggests the inhalation of a foreign body.

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