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:
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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