Chest tightness variant asthma (CTVA): reconfirmed and not generally appreciated

In 2013, Shen et al. published a report in which they described 24 patients with asthma whose sole presenting clinical manifestation was chest tightness (1). In doing so, these investigators have reminded us that: (I) asthma can present with a variety of symptoms; (II) physiological testing for bronchial hyperresponsiveness is very important to assess for the possibility of symptomatic asthma; and (III) a favorable response to asthma therapy is necessary to confirm that the tests showing bronchial hyperresponsiveness are true and not false positive tests.