Asthma diagnosis: not always simple or straightforward…

Asthma is a complex and multi-faceted condition, encompassing a variety of phenotypes and endotypes (1,2), and the diagnosis is often not easy in real-word clinical practice due to the lack of a simple ‘gold standard’ diagnostic test. Textbooks of medicine describe the ‘classical’ asthma presentation of a patient with intermittent and variable symptoms of wheeze, breathlessness, cough and chest tightness, typically with a diurnal pattern and often with symptoms following exposure to triggers such as exercise, viral infections or aero-allergens. With such a classical history, particularly in a patient with associated risk factors such as a personal or family history of atopy, asthma is very likely.