Asthma is a chronic inflammatory airway disease. It is characterized by obstruction, hyperinflation, mucussecretion that’s leads to mucus plug formation, limitation of airflow.
Signs and Symptoms associated with Asthma:
- Recurring episodes of cough
- Chest tightness
- Breathlessness and wheezing
- Symptoms of asthma occur at night or in early morning, vary over time and in intensity
Triggers Causing Asthma or Attacks:
Triggers of asthmatic attack can be dueto a number of reasons. Following are few common reasons:
- Viral infections
- Allergen exposure
- Changes with weather
- Irritant such as smoke or strong smells
- Car exhaust fumes
- Increased air level of respirable particles like so2, no2, and ozone
- Exposure to aspirin , nonsteroidal anti-inflammatory drugs or dyes.
- Occupational asthma is triggered by different substances in the workplace and may occur weeks to years after initial exposure and sensitization.
Understanding Wheezing in Asthma:
Widespread, polyphonic high pitchedwheezes are commonly heard in asthma or during asthmatic attacks.Expiratory wheeze is heard with mild broncho-constriction.Inspiratory wheeze is heard in severe broncho-constriction. Pleasenote that the symptom of wheezing is not just typical to asthma itcan be also be produced in other diseases like tuberculosis , copd ,cardiac asthma , allergic bronchopulmonary aspergillosis ,eosinopphilic pneumonias etc.
Types of Asthma based on its causative factors:
- Gastric asthma-: Worsening of asthma after meals or breathlessness occurring only after meals is due to gastro-oesophageal reflux.
- Episodic asthma-: Patient has no respiratory symptoms between episodes of asthma.
- Exercise induced asthma-: Asthma is induced by exercise.
- Acute severe asthma (status asthmaticus)-: It is a medical emergency patient is hypoxic and cyanosed due to severe bronchospasm. It is characterized by tachypnoea(respiratory rate more than 30/minute) , tachycardia(pulse rate more than 130/minute) , sweating , altered level of consciousness , and an inspiration-expiration ratio of 1:3 or 1:4.
- Mild asthma-:Breathlessness only with activity PEF>70% predicted or personal best
- Moderate asthma-:Breathlessness interferes with limits of usual activity PEF<40-69% predicted or personal best
- Severe asthma-:Breathlessness at rest interferes with conversation PEF<40% predicted or personal best
Aspects that constitute a life threatening asthmatic attack :
Life threatening asthmatic attack can be defined as an episode inwhich a person is too breathless to speak and the person is alsoprofusely sweating. Such episodes are termed as life threatening dueto the following complications:
- Central cyanosis
- Patient cannot speake
- Confusion and altered consciousness
- Silent chest
- Severe hypoxaemia
- Unrecordable peak flow
In such cases it is best recommendedthat the patient rushes to a hospital and consults a pulmonologist atthe earliest.