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Asthma, causes and symptoms

Asthma, causes and symptoms

 What is asthma ?

Dfinition

Chronic inflammatory disorder of the Airways.  it involves Complex interaction between  many cell and inflammatory mediators. Inflammation can   partially or completely or reversible obstruction of the  airway.

Classification

Actually  they are  Three  types :  mild,  moderate and severe.

patients severity may classify by determining

1, symptoms (    Short acting beta agonist use  nocturnal symptoms)

2.  Interference with normal daily activities

3, Lungs function (  spirometry to determine  FEV1  & FVC )

4, Frequency of exacerbations

 

asthma causes and symptoms

Causes of asthma

  1. Allergens (  eg. Pollen,  house dust mite,  animal dander,  mould,  cockroach,  food)
  2.  occupational exposure ( eg.  chemical  irritants,  frour , wood,  textile dusts.)
  3.  viral respiratory tract infection
  4.  Exercise
  5.  Emotions ( eg,  anxiety, Stress,  hard laughter,  crying)
  6. Exposure to irritants ( eg.Strong orders,  chemicals,   fumes )
  7.  Environmental exposure (  weather changes,  cold air,  Sulphur dioxide,  cigarette smoke )
  8.  drugs like NSAID ( Aspirin,  Ibuprofen etc ), Antiadrenergic and cholinergic drugs( eg.  beta adrenergic blockers,   Botanical)
causes of asthma

Clinical evaluation of asthma

physical finding

Physical findings depend on the severity of the underlying exacerbation

Mild exacerbation

Symptoms
  • Breathless while walking,  speaks in sentences, Moderate   wheezing
  • FEV1 or FVC< 70 % of normal
  •  Arterial pH :Normal or increase
  • PaO2:Normal or decrease
  • PaCO2: Normal or decrease

Moderate exacerbation

Symptoms
  • Dyspnea while at rest, in phrases, Loud wheezing throughout expiration
  • FEV1 / FVC:<40 % of normal (40-70)%
  • Peak expiratory flow rate (PEFR)< 50% of normal
  •  Arterial pH :Increase
  • paO2: <70 mm Hg
  • paCO2:> 30 mm Hg

Severe  exacerbation

Symptoms
  • Breathless while at rest,
  • Speaks in words loud wheezing,
  • Coughing
  • difficulty speaking,
  • Accessory chest muscle use and chest hyperinflation
  • FEV1 / FVC; <25% of normal
  • Peak expiratory flow rate (PEFR)< 33% of normal
  • Arterial pH ; Normal or decrease
  • paO2: < 60 mm Hg
  • paCO2; > 42 mm Hg
  • Respiratory failure
Symptoms
  • Severe respiratory distress,
  • Confusion lethargy,
  • cyanosis
  • disappearance of breath sound and pulsus paradoxus > 12 mm Hg
  • FEV1 / FVC; <25% of normal
  • Arterial pH ; Extremely decrease
  • PaO2:  Decrease
  • PaCO2: Extremely increases.

Acute exacerbation

common findings are

  • Shortness of breath
  • Wheezing
  • Chest tightness
  • Cough
  • Tachypnea  and tachycardia
  • Pulsus paradoxus
Breath difficulty and coughing

Diagnostic test results

A. Pulmonary function test

Determine the degree of airway obstruction  recommended spirometry in all asthma patients greater than 5 years old. Breathing test Include spirometry and Speak  flow meter testing,

 

  1. Forced expiratory volume in 1 second ( FEV1 ) and  forced vital capacity (FVC) both decrease during an  acute exacerbation.
  2. Residual volume (RV) and total lung capacity (TLC) may increase .
  3. Peak expiratory flow rate (PEFR) can be used to monitor or control of asthma

B. Blood analysis

White blood cell count it may be increased due to acute exacerbation

C . Arterial blood gas measurement

1. Early stage PaCO2  decrease

Gradually PaCO2  increase Due to  acute exacerbation

D.  Electrocardiogram (ECG)  may show sinus tachycardia
E. Chest radiograph may be normal or cloud detect accompanying Pneumothorax,  atelectasis  or pneumonia.

sign of respiratory distress include

  •  inability to East akin sentence or ambulate owing to dyspnea,
  • Declining mental status
  • PEFR < 50%  of predicted
  •  Cyanosis
  •  suprasternal retractions,
  •  absence of respiratory sound
  •  increasing paco2
  •  unable to sleep for extended time because of shortness of breath

 Note:  patient with potentially fatal asthma should be quickly  identify and aggressively managed Need to hospitalization.

Prevention and treatment of asthma

Exercise-induced bronchospasm (EIB )

You can prevent exacerbation Due to exercise By using medication .

1.1, Short acting beta agonist ( eg. Albuterol) Should be administered 15 minutes before exercise.

1.2,  long acting  beta agonist and formoterol should be administered 30 to 60 mins  before exercise.

Concurrent disease

Allergic rhinitis sinusitis and Gastroesophageal Reflux disease (GERD),  vocal cord dysfunction and obstructive sleep apnea  frequently coexist with asthma. It should be better to management of this concurrent disease by medication with Asthma treatment.

2.1. For Gastroesophageal Reflux disease  Medication should be use  such as PPI (eg. esomeprazol, Pantoprazol) or H2 receptor antagonist (eg, Famotidin)

2.2. For allergic rhinitis medication should be used such as antihistamine ( eg. rupatidin. cetirizine)

 

There are more different factors which may affect asthma condition. To prevent asthma we should know well about asthma causes and symptoms.

If anyone want to more information please send to me your question through the given email address.

Email address: mallicktarun@rocketmail.com

For getting treatment base suggestion please contact or request an appointment.

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