Asthma is a chronic disorder of the respiratory system, which causes inflammation of the airways (bronchial tubes). This leads to constriction and swelling of airways, causing difficulty in breathing. When a person is exposed to any triggering factor, histamine and other chemical agents are released by the body's immune system. This can cause inflammation of the bronchial tubes, which leads to narrowing and clogging of the airways. The inflamed tissues produce thick, sticky mucus which can cause further clogging of the airways. This mucus may accumulate within the lungs, causing breathing difficulties. The tightened muscles are wrapped around the airways, which constricts them further. Chronically inflamed bronchial tubes become extremely sensitive to allergens or irritants. This condition is known as 'bronchial hyper-reactivity'. An asthma attack may be triggered by upper respiratory tract infections, Gastroesophageal Reflux Disease (GERD), inhaling dry and cold air, and certain allergens such as pet shedding and saliva, pollens, dust mites, molds, and tobacco smoke.
Symptoms
During an acute asthma attack, a series of changes occur within the lungs and airways, which lead to the symptoms. Inflammation, excess mucus production, and bronchospasm lead to the various symptoms of an asthma attack such as shortness of breath, wheezing and coughing. The symptoms of this attack may vary in severity and duration from person to person. Early warning signs are as follows:-
- Headache
- Chronic cough
- Itchy throat
- Difficulty in talking for a prolonged period
- Disturbed sleep patterns
- Difficulty in breathing
- Tightness of the chest
- Wheezing
Wheezing is one of the most frequently experienced symptoms. It is a whistling or hissing sound that accompanies breathing. Wheezing is heard usually during exhalation; however, it can also occur during inhaling. The breathing itself becomes laborious. When these early signs are noticed, one should seek immediate medical attention in order to prevent a severe attack. Mild attacks are more common and they can be relieved within a few hours after appropriate treatment.
Severe asthma attacks are less frequent. However, they may last for a longer duration and require immediate and advanced medical attention. The symptoms develop gradually and may become serious within 6-48 hours. There are certain signs that indicate increasing severity of an attack. These signs include
a low peak expiratory flow (PEF) rate, increased pulse rate, increased wheezing, fatigue, and restlessness.
In case of a severe attack, there may be life-threatening symptoms. Some typical symptoms are breathlessness, difficulty in talking, nasal flaring, increased pulse or heartbeat, chest pain, sweating and peak flow reading in the 'red zone'.
Silent chest is an important sign of severe asthma attack. There is no wheezing during inhalation or exhalation. There may be certain symptoms of
cyanosis such as gray or bluish tint to skin, lips, and nail beds, owing to low levels of blood oxygen caused by inadequate intake from faulty breathing. There may be a feeling of anxiety, reduced alertness, severe drowsiness, or confusion.
An extremely severe attack may lead to respiratory arrest and death. An asthma attack is considered a medical emergency and requires immediate medical assistance.
Diagnosis and Treatment
The symptoms of asthma attack may resemble other respiratory disorders such as respiratory tract infection, bronchitis, and emphysema. Hence, an accurate diagnosis of asthma is essential to decide the appropriate treatment schedule. The severity of asthma symptoms is monitored with the help of pulmonary function tests, such as peak flow reading, spirometry, nitric oxide measurement, and pulse oximetry. Treatment focuses on managing the symptoms, maintaining normal lung function, and preventing possible fatality from severe attacks. Certain medications such as short-acting beta agonists, oral corticosteroids, leukotriene inhibitors such as montelukast and zileuton, and methylxanthines can be used to reduce inflammation in an acute asthma attack. The use of HFA inhalers (hydrofluoroalkane) can help in controlling the symptoms of breathlessness. If the symptoms are life-threatening, then intubation and mechanical ventilation become necessary to assist breathing.
The causes of asthma are associated with genetic, chemical, and environmental factors. Some common triggering factors for asthma are viral infections such as cold and flu, allergies to certain medicines, pollens, dust mites, food allergies, irritants such as cigarette smoke or dust, and certain chemicals. Asthma could also be caused by certain exercises performed in cold and dry air. The best way to prevent an asthma attack is to avoid any contact with triggering agents. You need to identify the allergic triggers and avoid exposure to them as much as possible. With the help of appropriate medical treatment, nutritious diet, and a healthy lifestyle, you can avoid these troublesome symptoms and enjoy excellent respiratory health.
