Asthma Attacks, Yet Again.

Asthma is one of those common chronic inflammatory disease of the airways that causes airway hyperresponsiveness, mucosal edema, and mucus production. This hyperresponsiveness and inflammation ultimately leads to recurrent episodes of asthma symptoms which are cough, chest tightness, wheezing, and difficulty of breathing (dyspnea). Asthma is different from other obstructive pulmonary diseases in that it is largely reversible. This can be reversible either spontaneously or with treatment. People suffering from asthma may have asthma symptom-free episodes alternating with acute exacerbations, which can be very dangerous too. Acute exacerbations can last from minutes to days.

Asthma affects people of ages and may really affect activities of daily living such as going to school and work. Working conditions and environment becomes a huge factor.  Asthma accounts for a huge number of visits to medical institutions. An allergy is the strongest predisposing factor for asthma. It can be an allergy with dust particles, pollen grains, animal dander, weather and humidity fluctuations, and physical activity. Airway obstruction becomes a problem because the inflammatory responses from a certain allergen causes the bronchi to constrict and hypersecretion of mucous also blocks the airways. A blockage to the airway cannot facilitate breathing and also circulation of oxygen, thus airway obstruction needs to be immediately taken cared of before solving breathing or circulatory problems.

Causes of Asthma

Allergy is the culprit for the signs and symptoms of asthma and chronic exposure to such irritants may predispose a person to develop asthma. Common allergens can be seasonal (grass, tree, and weed pollens) or perennial such as molds, dust, roaches, or animal dander. Common triggers for asthma symptoms and exacerbations in persons suffering from asthma include airway irritants such as air pollution, heat and cold, fluctuations in weather and humidity, strong odors, chemicals, perfumes, smoke, and tobacco. Exercise, stress, emotional upsets, weak immune system, sinusitis with post nasal drips, medications, viral respiratory tract infections, common cold, and gastroesophageal reflux disease or GERD, can also trigger an acute exacerbation. Some food allergies can also trigger symptoms of asthma and may also lead to a life-threatening acute exacerbation. Prevention is better than cure so once you have signs and symptoms of a certain upper respiratory infection, whether bacterial or viral, it should be treated at once to avoid complications of asthma. Active or secondary cigarette smoking may trigger an acute exacerbation to some people, while in some persons diagnosed with asthma cigarette smoking does not cause any unusual symptoms.

Signs and Symptoms of Asthma

The three common symptoms of asthma are cough, difficulty in breathing, and wheezing. The adventitious breath sound characteristic in asthma is sibilant wheezing sound due to bronchospasm, and buildup of secretions. These are continuous musical, high-pitched, whistle-like sounds heard during inspiration and expiration caused by air passing through narrowed or partially obstructed airways. This may clear with coughing. A cough can be productive or non-productive. Orthopneic sitting position is a sign that the person is suffering from difficulty in breathing. This sitting position allows maximum expansion of the lungs. Expiration requires effort and becomes prolonged. As the exacerbation progresses, diaphoresis, cool clammy palms and feet, tachycardia, and a widened pulse pressure may occur along with hypoxemia and central cyanosis, which is a later sign of poor oxygenation of tissues. Symptoms of exercise-induced asthma include maximal symptoms during exercise, fatigue, absence of nocturnal symptoms (cough, cold, sinusitis, post-nasal drip at night or when a person suffering asthma wakes up in the morning.) Symptoms of exercise-induced asthma include a choking sensation during exertion. Fatigability is also one symptom. The person with acute attack cannot perform activities of daily living because exertion brings about difficulty in breathing.

The signs and symptoms may vary from one person to another. A particular triggering factor causing the symptoms of asthma may also be different form one person to another. Some people may have asthma attacks when exposed to furry animals while some may not be allergic to it. Some may be allergic to fluctuating temperature and weather changes while some are not. Some may have symptoms of asthma to a particular chemical agent or detergent, while some may not. Some people who have asthma may produce symptoms of asthma when subjected to certain foods, such as seafoods, chicken or legumes, while some are allergic to other types of food.

Complications of Asthma

This may include status asthmaticus, respiratory failure, pneumonia, and atelectasis. All of these can really be life-threatening and require immediate intervention to relieve symptoms.  Hypoxemic episodes during attack will require the administration of oxygen and monitoring of pulse oximetry and arterial blood gases. Deviations from normal arterial blood gases may predispose a person to other complications. Difficulty of breathing also predisposes a person to difficulty in swallowing and communicating. A person’s diet may be at great risk. Intravenous fluids and parenteral nutrition are administered to promote balance in fluid and nutritional status of the person. Aspiration pneumonia can be a deadly thing once a person with difficulty of swallowing accidentally aspirates fluids or food particles into the airways and could automatically lead to death. Strict aspiration precaution during meals should be observed.