Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification.
- X-ray of the chest (X-ray thorax/chest), in two planes – if pneumonia (pneumonia), structural lung disease, chronic cough (duration > 8 weeks) or presence of warning signs (see below “Symptoms – complaints”) are suspected.
- Spirometry (basic examination as part of pulmonary function diagnostics) – if chronic obstructive pulmonary disease (COPD), chronic cough (duration > 8 weeks) or presence of warning signs (see below “Symptoms – complaints”) is suspected.
- Peak flow measurement – measurement of airflow, more specifically the respiratory flow rate, in a forced strong expiration (exhalation) – if bronchial asthma is suspected.
- Methacholine test (methacholine provocation test, English Methacholine Challenge Test) – nonspecific, inhalation provocation test to measure bronchial obstruction (constriction (obstruction) of the bronchi) and hyperreactivity (excessively strong (“exaggerated”) reaction to a stimulus), for example, in bronchial asthma.
- Computed tomography of the thorax/chest (thoracic CT) – if tumors are suspected.
- Magnetic resonance imaging of the thorax / chest (thoracic MRI) – if tumors are suspected.
- Gastroscopy (gastroscopy) – for suspected gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
- Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – if heart failure (cardiac insufficiency) is suspected.
- Echocardiography (echo; heart ultrasound) – if heart failure or pulmonary embolism is suspected.
- Bronchoscopy (lung endoscopy), if necessary with biopsy (tissue sampling) – is considered the gold standard for the diagnosis of pathological changes in the bronchial tract.
Stage diagnostics:
- X-ray chest/thorax and pulmonary function testing; if chest x-ray and pulmonary function normal: 2nd step; nonspecific bronchial provocation.
- Methacholine test (methacholine provocation test, English methacholine challenge test).
- Computed tomography (CT) or bronchoscopy (lung endoscopy); at the end of the diagnosis is always indicated bronchoscopy!
