Asthma- Symptoms, Causes and treatment

Asthma is a condition of paroxysmal, reversible airway obstruction. It is a syndrome characterized by increased responsiveness of the trachea and bronchi to various stimuli. Asthma is manifested by acute, recurrent or chronic attacks of widespread bronchial-bronchiolar narrowing.

Types 

A. Extrinsic
(Atopic); In children

B. Intrinsic
(Non-Atopic); In Adults

Signs and Symptoms of Asthma

A. General 

  • Cough with or without sputum production
  • Intercostal retractions
  • Shortness of breath that gets worse with exercise or activity
  • Wheezing
    a. Comes in episodes
    b. May go away on its own
    c. Improves with bronchodilators
    d. Usually begins suddenly
  • Abnormal breathing pattern –Breathing out takes more than twice as long as breathing in
  • Breathing temporarily stops
  • Chest pain
  • Nasal flaring
  • Tightness in the chest

B. Life-Threatening

  • Bluish colour to the lips and face
  • Decreased level of alertness ( severe drowsiness or confusion)
  • Extreme difficulty in  breathing
  • Rapid pulse
  • Severe anxiety due to shortness of breath
  • Sweating

Causes

  1. Triggers–
  • Weather (sudden changes in temperature, fog, wind, thunderstorm)
  • Exercises (running)
  • Stress
  • Coughing
  • Repeated laughing
  • Drugs (NSAIDs, Beta/Alpha-blockers)

    2. Inducers
  • Infections (Pertussis, Mycoplasma, Viral URTI, Respiratory syncytial virus bronchiolitis)
  • Cigarette smoking

3. Allergens

( house dust, mite, tree pollen, feathers, paint, smoke, animal, dander, milk, eggs, nuts, chocolates, fish, shellfish, strawberries and many more..)

Investigations

  • Allergen specific IgE
  • Arterial blood gas analysis
  • Chest x-ray
  • Lung function tests
  • PBF
  • PEFR
  • Skin tests
  • Sputum test
  • Total Serum IgE
  • Spirometry

 Treatment

 A. In Chronic cases

  •  Medications
  •  Self-Management — Educating about the nature of treatment and how to use it, recognition of acute exacerbations, self-assessment.
  • PEFR monitoring
  • Non-Pharmacological, like- Stopping smoking, Reducing weight, Avoiding allergens, Family therapy for–(Depression, Anxiety, Denial of disease)

B. In Acute severe cases

  1. Oxygen—Through nasal prongs or masks
  2. Corticosteroids
  3. Beta-agonists—Adrenaline, Nebulized salbutamol/terbutaline, Parenteral beta-agonists, Anticholinergic, Aminophylline
  4. Antibiotics
  5. Ventilators

Complications

Respiratory—

  • Atelectasis lobular
  • Bronchiectasis
  • Subcutaneous emphysema
  • Mediastinal emphysema
  • Spontaneous pneumothorax
  • Cystic degeneration of the lungs
  • Spontaneous rib fracture
  • Recurrent bronchitis
  • Pneumonia
  • Respiratory failure
  • Cor pulmonale

Cardiac

  • Dysrhythmias
  • Myocardial infarction

Hypokalemia

Acute myopathy

Nausea and vomiting (dose-related)

Prevention

  • Identify and avoid the allergen/triggers
  • Hypo sensitizationRaising immunity to the offending allergen
  • Psychotherapy
  • Chest exercise
  • Breathing exercises like pranayama including anulom-vilom and kapaal bhaati improve the lungs function significantly and help in the prevention of Asthma.

1 thought on “Asthma- Symptoms, Causes and treatment”

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