Definition: Asthma is an inflammatory disorder of the airways, characterized by periodic attacks of wheezing, shortness of breath, chest tightness, and coughing.
Alternative Names: Bronchial asthma; Exercise induced asthma - bronchial; Reactive airways disease (RAD)
Causes, incidence, and risk factors:
Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted. When an asthma attack occurs, the muscles of the bronchial tree become tight and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing sound. Mucus production is increased.
Most people with asthma have periodic wheezing attacks separated by symptom-free periods. Some asthmatics have chronic shortness of breath with episodes of increased shortness of breath. Other asthmatics may have a cough as their predominant symptom. Asthma attacks can last minutes to days and can become dangerous if the airflow becomes severely restricted.
In sensitive individuals, asthma symptoms can be triggered by inhaled allergens (allergy triggers), such as pet dander, dust mites, cockroach allergens, molds, or pollens. Asthma symptoms can also be triggered by respiratory infections, exercise,
cold air, tobacco smoke and other pollutants, stress, food, or drug allergies. Aspirin and other non-steroidal anti-inflammatory medications (NSAIDS) provoke asthma in some patients.
Asthma is found in 3-5% of adults and 7-10% of children. Half of the people with asthma develop it before age 10, and most develop it before age 30. Asthma symptoms can decrease over time, especially in children. Many people with asthma have an individual and/or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies or evidence of allergic problems
Symptoms:
o wheezing
o usually begins suddenly
o is episodic
o may be worse at night or in early morning
o aggravated by exposure to cold air
o aggravated by exercise
o aggravated by heartburn (reflux)
o resolves spontaneously
o relieved by bronchodilators (drugs that open the airways)
o cough with or without sputum (phlegm) production
o shortness of breath that is aggravated by exercise
o breathing that requires increased work
o intercostal retractions (pulling of the skin between the ribs when breathing)
Additional symptoms that may be associated with this disease:
o nasal flaring
o chest pain
o tightness in the chest
o abnormal breathing pattern, in which exhalation (breathing out) takes more than twice as long as inspiration (breathing in)
o breathing which temporarily stops
o coughing up blood
Emergency symptoms: (seek immediate medical attention)
o extreme difficulty breathing
o bluish color to the lips and face
o severe anxiety
o severely rapid pulse(greater than 120 bpm)
o perfuse sweating
o decreased level of consciousness (severe drowsiness or confusion) during an asthma attack
Signs and tests:
Listening to the chest (auscultation) during an episode reveals wheezing. However, lung sounds are usually normal between episodes.
Tests may include:
o pulmonary function tests
o peak flow measurements
o chest X-ray
o allergy testing by skin testing or serum tests
o arterial blood gas
o eosinophil (a type of white blood cell) count. Now that you know what to look for, let's discuss what you can do if you find that you have asthma.
(See Asthma - Treatment and Tips).