A small but rare study out of China is examining an atypical form of asthma, known as chest pain variant asthma (CPVA), and clinician inexperience in treating the condition. Although not extremely common in clinical practice, CPVA is still a recognized form of asthma where chest pain is the primary presenting symptom, affecting a subset of asthma patients who may not experience typical symptoms like wheezing.
The study, “Clinical Characteristics of 31 Patients With Chest Pain Variant Asthma,” was recently published in the Journal of Asthma and Allergy. It was designed to analyze symptom characteristics, lung function and chest imaging features to bring attention to and improve education of this form of asthma among clinicians.
The study, conducted at Beijing Chao-Yang Hospital, analyzed 31 patients diagnosed with CPVA. Most of these patients were women, with an average age of 47 years. The chest pain experienced by these patients was often dull and mild, with no fixed location and lasted for an average of four months.
According to the study’s authors, CPVA is relatively rare and challenging to diagnose due to its atypical presentation. Patients often visit cardiologists or gastroenterologists before receiving a correct diagnosis. The study emphasizes the importance of recognizing CPVA's symptoms, lung function and chest imaging features to improve diagnosis and treatment.
Key findings from the study found that 64.5% of CPVA patients exhibited type 2 inflammation, characterized by elevated levels of eosinophils and immunoglobulin E. Despite normal lung function in some patients, 71% of patients had abnormalities on chest CT scans, including bronchiolar and bronchial abnormalities. Additionally, 35.5% of patients had allergic rhinitis, highlighting the need for comprehensive management of asthma and its comorbidities.
Most patients in the study responded well to inhaled corticosteroids and long-acting beta2-agonists, with significant relief of chest pain within a few weeks. The study underscores the importance of early recognition and treatment to prevent complications and improve patient outcomes.
Although asthma is a growing, global concern, the condition is a significant public health challenge in China, according to the results of the China Pulmonary Health study. In China alone, there are about 45.7 million adults with asthma among those aged 20 years or older.
