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Asthma symptoms and types of asthma

 Asthma symptoms


Asthma symptoms

Asthma is a chronic inflammatory disorder of the airways. It is associated with airway hyper- responsiveness that leads to recurrent episode of wheezing, breathlessness, chest tightness and coughing. 

Asthma signs and symptoms 

Asthma is an atopic disease. Usually presents in childhood. Patients present with 4 cardinal features. They are 

       Wheeze (it is a musical sound heard from a distance, due to small airway obstruction)

       Breathlessness 

      Chest tightness

      Cough


Usually people come with severe breathlessness or acute exacerbation of asthma. Typical history and examination help to diagnose the disease. 

Asthma characteristically displays a diurnal pattern. It becomes severe in the early morning. 


Important features help to establish a diagnosis

       Age of onset: any age,  but usually less than 40 years

       Smoking history: may or maybe 

       Allergy: Common, Rhinitis, eczema, skin prick positive, eosinophilia may be found. 

      Family history: common

      Cardinal features: Dyspnea, cough, wheeze, and chest tightness. 

      Diurnal variation more


Clinical signs in respiratory examination

               Breath sound: vesicular with prolonged expiration

               Added sounds: High pitched rhonchi  are present in both sides of the chest, more marked on expiration.  

Types of asthma

                  Intermittent asthma

                  Persistent asthma

                 Acute exacerbation 

                 Special variants

1. Intermittent asthma: 

About 2 or less than 2 night symptoms in month. Between the episodes, the patient remains symptoms free and lung function test are normal. 

2. Persistent asthma:  

Frequent attacks at least more than two occasions on a month. In between the attack, the patient may or may not have symptoms and lung function tests are abnormal, except in mild case. 

3. Acute exacerbation: 

Loss of any class or variants of asthma. It again classified as 

            Mild- The patient is dyspneic, but can complete a sentence in one breath.

           Moderate- The patient is more dyspneic, cannot complete a sentence in one breath.

           Severe- The patient is severely dyspneic, talks in words and may be restless, even unconscious.

4. Special variants- 

                 Cough variant asthma

                 Exercise induced asthma

                 Occupational asthma

                 Drug induced asthma (aspirin, other NSAIDs, Beta blockers)

Another classification of asthma:

Intrinsic asthma 

When no causative agent can be identified. It is not allergic. Usually begins after the age of 30 years, tends to be more continuous and more severe. 

Extrinsic Asthma

 when definite external cause is present. there is a history of allergy to dust mite, animal danders, pollens, fungi, etc. It occurs commonly in childhood and usually shows seasonal variations. 

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