Broncoconstrição induzida pelo exercício
Exercise-induced bronchoconstriction
João Cardoso Lopes, Álvaro Nogueira, Helena Pereira, Pedro Botelho Alves
Resumo
A broncoconstrição induzida pelo exercício (BIE) é caracterizada pelo estreitamento transitório e reversível das vias aéreas du‑ rante ou após o exercício físico, sendo uma condição frequente em crianças, adultos e, em particular, em atletas. Resulta so‑ bretudo da inflamação das vias aéreas, do arrefecimento do ar inalado e/ou da desidratação da mucosa respiratória induzida pela hiperventilação. Os sintomas mais comuns incluem tosse, sibilância, dispneia e opressão torácica, podendo traduzir-se em fadiga precoce e limitação do desempenho físico. O diagnóstico baseia-se na história clínica, exame objetivo e provas de função respiratória, recorrendo a testes de broncoprovocação específicos para documentar uma diminuição do FEV1 (volume expiratório for‑ çado no 1° segundo) após o esforço ou após estímulos indiretos. A abordagem terapêutica combina medidas não farmacológicas – como otimização do aquecimento pré-exercício e modificação de fatores ambientais – com medidas farmacológicas, incluindo agonistas beta-2 de curta duração, corticosteroides inalados e antagonistas dos receptores dos leucotrienos, selecionados e ajustados de acordo com o contexto clínico e a presença de asma subjacente. Um seguimento estruturado, idealmente em articula‑ ção com equipes de Medicina Desportiva e Imunoalergologia, é fundamental para garantir o controlo dos sintomas, a segurança e a manutenção da prática de atividade física.
Palavras-chave
Abstract
Exercise-induced bronchoconstriction (EIB) is defined as a transient, reversible narrowing of the airways that occurs during or after physical exercise and is frequent in children, adults, and athletes. It results primarily from airway inflammation, cooling of inhaled air, and/or dehydration of the respiratory mucosa caused by hyperventilation. Typical symptoms include coughing, wheezing, dyspnea, and chest tightness, which may also manifest as early fatigue and reduced exercise performance. Diagnosis relies on a detailed clinical history, physical examination, and pulmonary function tests, using specific bronchoprovocation protocols to document a reduction in post-exercise forced expiratory volume in one second (FEV1) or after indirect stimuli. Management combines non-pharmacological strategies – including optimization of pre-exercise warm-up routines and reduction of environmental triggers – with pharmacological measures such as short-acting β2-agonists, inhaled corticosteroids, and leukotriene receptor antagonists, tailored to the clinical context and the presence of underlying asthma. Structured follow-up, ideally involving specialists in sports medicine and allergy, is essential to ensure adequate symptom control, patient safety, and maintenance of regular physical activity
Keywords
Referências
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Submetido em:
16/11/2024
Aceito em:
21/11/2025
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