Although classically asthma is characterised by variable airflow obstruction and inflammation, leading to symptoms of breathlessness, wheeze, chest tightness and cough, it can present with a broad spectrum of symptoms that have a wide differential diagnosis. Clinical examination is frequently entirely normal and clinical history alone is not sufficient to diagnose asthma. There is over-reliance on short-acting beta-agonists and a widespread underuse of inhaled corticosteroids. In mild to moderate disease, fluctuating symptoms can lead to an over-reliance on short-acting reliever treatment at the expense of preventative inhaled steroids. This risks the concealment of deteriorating symptoms and the potential build-up of critical airways inflammation.