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An adolescent with cough, shortness of breath, and wheezing has a differential that includes asthma, pneumothorax, pneumonia, achalasia, myocarditis, and congestive heart failure (HF). Patients with asthma, a chronic inflammatory disease of the airways, typically have recurrent episodes of airflow obstruction resulting from edema, bronchospasm, and increased mucus production in the airways. Children frequently have associated seasonal allergies (allergic rhinitis) and eczema (atopic dermatitis), with these three conditions forming what is known as the atopic triad. This patient does not have a history of allergic diseases or wheezing and on physical exam is not currently wheezing.
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