Asthma
Asthma is a chronic airway condition causing recurring wheeze, cough, chest tightness, and shortness of breath, managed per the 2026 Global Initiative for Asthma (GINA) strategy and the 2020 NAEPP guideline update.
Symptoms
Wheezing, cough (often worse at night or with exercise), chest tightness, and shortness of breath that vary in intensity and come and go.
Causes and risk
Allergens, respiratory infections, exercise, cold air, smoke, and stress are common triggers; family history and childhood allergic conditions raise risk.
How it is evaluated
Spirometry confirms the diagnosis and severity classification. GINA emphasizes ongoing control-based assessment, while NAEPP retains traditional intermittent/mild/moderate/severe persistent categories for initial staging.
Treatment
GINA now positions low-dose ICS-formoterol as the preferred anti-inflammatory reliever across all treatment steps, replacing SABA-only reliever therapy as the default -- a meaningful shift from older teaching. Controller therapy is stepped up or down based on symptom control, and ICS-formoterol should not be paired as a reliever alongside a different ICS-LABA maintenance inhaler.
When to seek care
Severe shortness of breath, difficulty speaking in full sentences, blue lips, or a rescue inhaler not helping are signs of a severe exacerbation requiring emergency care.