During PPE screening, which findings suggest asthma in an athlete?

• A. All athletes must undergo PPE; identification includes chest tightness, coughing, dyspnea, difficulty sleeping, wheezing, inability to catch breath, use of accessory muscles; family history; testing may include stress ECG, upper airway evaluation, ECG, or upper endoscopy
• B. Asthma is diagnosed solely by self-reported symptoms
• C. PPE is optional for athletes and not routinely performed
• D. Testing is limited to resting spirometry only

Answer: (A)

In PPE screening, asthma is most likely indicated by symptoms that occur with exercise or at night, such as chest tightness, coughing, shortness of breath, wheezing, and trouble sleeping due to breathing problems. Noting the use of accessory muscles during breathing also signals more significant airway involvement. A family history of asthma increases the likelihood, though it doesn’t by itself diagnose the condition. Because asthma can be variable and triggered by exercise, resting findings alone may miss it, so the PPE emphasizes following up on reported symptoms with objective testing like spirometry with bronchodilator response or an exercise challenge when appropriate. Statements that asthma is diagnosed solely by self-report, that PPE is optional, or that testing is limited to resting spirometry don’t align with how PPE screens identify potential airway disease and guide further evaluation.