Exercise-induced pulmonary syndromes.

When respiratory distress occurs in the exercise arena, the clinician must differentiate between a potential serious bout of EIA or the commoner EIB. The physician's game day medical kit should include epinephrine for initial treatment in suspected EIA. Sports medicine personnel need to maintain a high index of suspicion for EIB in athletes at risk and confirm the diagnosis with a treadmill exercise challenge test. Initial pharmacologic management should consist of a trial of albuterol inhaler use 15 minutes before exercise. Early identification and treatment of EIB may enhance sports performance as well as enjoyment.