Exercise-Induced Bronchoconstriction in a Chilean Professional Female Soccer Player

Abstract

We present the case of a 27-year-old professional female soccer player with a history of atopic dermatitis and allergic rhinitis who experienced recurrent episodes of respiratory symptoms during soccer practice. Following an acute episode of cough, chest tightness, and dyspnea during an official match, a diagnostic suspicion of exercise-induced bronchoconstriction (EIB) versus asthma was established, as both conditions are frequently confused due to the similarity of their clinical presentation. Differentiation requires proper evaluation and objective diagnostic testing, as clinical symptoms alone are insufficient to distinguish between differential diagnoses. The player presented a high-risk profile, considering that female athletes with atopic dermatitis have increased susceptibility to EIB. The evaluation included physical testing with VO₂max (48 mL/kg/min) above the team average, optimal body composition (BMI 20.8 kg/m², fat mass 22.4%, muscle mass 43%), and baseline and post-bronchodilator spirometry, which ruled out persistent asthma and confirmed the diagnosis of EIB. Treatment was initiated with inhaled Budesonide 160 mcg/Formoterol 4.5 mcg twice daily, complemented by a progressive respiratory muscle training program with inspiratory training valve. After five months, the player achieved complete symptom remission, participating in 11 of 13 matches of the national championship with 855 minutes of play time without complications.

This case illustrates how EIB and asthma can be confused in clinical practice, highlighting the importance of precise differential diagnosis in professional athletes. Furthermore, it emphasizes the importance of early differential diagnosis and appropriate management of EIB in high-performance athletes. It underscores the effectiveness of combining pharmacological therapy with environmental measures and emphasizes the need for comprehensive pre-participation evaluation that includes specific screening to differentiate EIB from asthma in athletes with atopic phenotype and a multidisciplinary approach to optimize performance.