Problemi speciali
Il bambino intollerante allo sforzo
Exercise Intolerance In Children
Luciano Anfossi
SC di Pneumologia, SS di Allergologia, Ospedale Infantile “Regina Margherita”, Torino
Giugno 2012 - pagg. 375 -384
Abstract
Unexplained limitation to exercise is a common clinical problem in children and adolescents.
Exercise-induced asthma (EIA) is the most common manifestation. Bronchodilators
and other medications have been used in prevention and treatment of EIA and should allow
the majority of patients with asthma to perform regular physical activity. Although
asthma is the most common cause, dyspnoea on exertion can be a result of other causes.
Restrictive thoracic cage abnormalities (scoliosis and pectus deformities) can produce
dyspnoea only on exertion. Vocal cord dysfunction syndrome or the less common
exercise-induced laryngomalacia and tracheobronchomalacia are often attributed to
asthma. Most common is dyspnoea associated with normal physiologic exercise limitation
but other causes can include exercise-induced hyperventilation, supraventricular tachycardia
and other cardiac abnormalities. Spirometry, and exercise testing with cardiopulmonary
monitoring, including gas exchange, provide useful data to sort out the various
causes and avoid inappropriate treatments.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
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Il bambino intollerante allo sforzo
MESSAGGI CHIAVE
! Una difficoltà che si manifesti durante
attività fisiche, a vario grado di
intensità, può essere espressione di
molte condizioni, patologiche e non.
! Quando il sintomo predominante è
la dispnea, la broncostruzione da sforzo
rappresenta la condizione clinica
più frequente.
! Una diagnosi corretta di asma da
sforzo non può comunque basarsi
esclusivamente sui sintomi riferiti dal
paziente ma deve essere confermata
da test funzionali (test di provocazione
da sforzo).
! L’asma da sforzo può essere prevenuta
con opportuna terapia farmacologica
e non deve rappresentare un ostacolo
alla possibilità di svolgere una vita
attiva, pari a quella dei coetanei non
asmatici, e alla pratica di attività sportive,
anche a livello agonistico.
! Valutare con ECG, Rx torace ed ecocardiografia
ogni dispnea da sforzo in
cui non sia dimostrata un’alterazione
broncostruttiva o di tipo “laringeo”.
! Una indagine più approfondita, con
test da sforzo cardiorespiratorio, trova
indicazione in caso di sintomatologia
atipica, mancato controllo dei sintomi,
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Corrispondenza: lucianoanfossi@hotmail.it