Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with recurrent exertional dyspnea, chest tightness, and non-productive cough occurring during or within 15 minutes post-vigorous physical activity. Symptoms resolve spontaneously within 30-60 minutes of rest. No history of nocturnal symptoms or wheezing at baseline. Denies fever, chest pain, or syncope.
Clinical Examination Findings
General: Patient is in no acute distress. HEENT: Oropharynx clear, no nasal polyps or significant turbinate hypertrophy. Cardiovascular: Regular rate and rhythm, no murmurs or gallops. Respiratory: Lungs are clear to auscultation bilaterally at rest. No wheezing, rhonchi, or crackles. Forced expiratory maneuver does not elicit immediate bronchospasm in the office setting.
Treatment Protocol
Initiate pre-exercise prophylaxis with a short-acting beta-agonist (SABA) or inhaled corticosteroid/formoterol combination 15-30 minutes prior to physical activity. Emphasize proper warm-up protocols (10-15 minutes of low-intensity exercise). Advise use of a face mask or scarf in cold, dry environments to warm and humidify inspired air. Follow-up in 4-6 weeks to assess symptom control.