Abstract

The athlete with exercise-induced asthma (EIA) is no stranger in elite competitive sports. The clinical presentation is variable and may resemble an attack of acute asthma or merely dyspnea and poor athletic performance. The diagnosis can be made using an exercise challenge test; the patient exercises at an intensity of 90 of maximum heart rate for 6-8 min on a treadmill or cycle ergometer. Postexercise pulmonary function tests (FEV1.0, MMEFR) are compared with pretest values; a difference of 15 is significant. Alternatively, a histamine or methacholine challenge test can assess the bronchial reactivity of the airways and gives results comparable to exercise testing. The management of the asthmatic athlete goes beyond the use of pharmaceutical agents. The intensity, duration, and type of exercise are important considerations. The environment clearly plays a major role in the pathophysiology of EIA, as does the state of aerobic fitness of the athlete. Warm-up exercises can attenuate the response of the airways to physical activity. In the prevention of EIA the beta-2 adrenergic agonists, administered in aerosol form, are very effective and are the drugs of choice. Other agents, in particular, sodium cromoglycate, can be used in combination with a beta-2 agonist. The use of glucocorticosteroids in the management of EIA is controversial. Several of the commonly used pharmacological agents are not permitted for use by competitive athletes, and the physician must be aware of the current list of banned substances. Verf.-Referat