Expert consensus on the diagnosis and treatment of chest tightness variant asthma in China

Abstract

Chest tightness variant asthma (CTVA) is an atypical asthma, characterized by chest tightness as the only or main clinical manifestation. Due to its lack of typical asthma symptoms and signs, it is prone to misdiagnosis or missed diagnosis. Comprehensive chest tightness symptoms and objective evidence of variable airflow restriction, especially bronchial provocation test, are important criteria of diagnosing CTVA. Patients with CTVA also need to be differentiated from patients with chronic obstructive pulmonary disease, coronary atherosclerotic heart disease, gastroesophageal reflux disease and other diseases. The principle of CTVA treatment is the same as that of typical asthma, and most patients have a good prognosis after standardized asthma treatment. Based on recently research in China, the Asthma Group of the Chinese Thoracic Society organized relevant experts from various specialities, including respiratory and critical care medicine, cardiology, gastroenterology, psychiatry, and traditional Chinese medicine, to develop the expert consensus. This consensus includes: definition, epidemiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, evaluation, treatment, management education, and prevention of CTVA, and it also proposes a flowchart for CTVA diagnosis and treatment. This expert consensus is intended to provide with expert opinion in improving the understanding and standardized diagnosis and treatment of CTVA among clinicians in China.