Asthma
What are the symptoms of Asthma?
Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom. Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted. Symptoms include:
- Cough with or without sputum (phlegm) production
- Pulling in of the skin between the ribs when breathing (intercostal retractions)
- Shortness of breath that gets worse with exercise or activity
- Wheezing:
- Comes in episodes with symptom-free periods in between
- May be worse at night or in early morning
- May go away on its own
- Gets better when using drugs that open the airways (bronchodilators)
- Gets worse when breathing in cold air
- Gets worse with exercise
- Gets worse with heartburn (reflux)
- Usually begins suddenly
- Emergency symptoms:
- Bluish color to the lips and face
- Decreased level of alertness such as severe drowsiness or confusion, during an asthma attack
- Extreme difficulty breathing
- Rapid pulse
- Severe anxiety due to shortness of breath
- Sweating
- Associated symptoms include:
- Abnormal breathing pattern (breathing out takes more than twice as long as breathing in)
- Breathing temporarily stops
- Chest pain
- Nasal flaring
- Tightness in the chest
What causes Asthma?
Asthma is caused by inflammation in the airways. When an asthma attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by. In sensitive individuals, asthma symptoms can be triggered by breathing in allergy-causing substances (called allergens or triggers). Common asthma triggers include:
- Animals (pet hair or dander)
- Dust
- Changes in weather (most often cold weather)
- Chemicals in the air or in food
- Exercise
- Mold
- Pollen
- Respiratory infections, such as the common cold
- Strong emotions (stress)
- Tobacco smoke
- Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.
Who is at highest risk?
Many people with asthma have an individual or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.
Diagnosis
Allergy testing may be helpful in identifying allergens in people with persistent asthma. Common allergens include pet dander, dust mites, cockroach allergens, molds, and pollens. Common respiratory irritants include tobacco smoke, pollution, and fumes from burning wood or gas. The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes. Tests may include:
- Arterial blood gas
- Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin)
- Chest x-ray
- Lung function tests
- Peak flow measurements
When to seek urgent medical care?
- Call for an appointment with your health care provider if asthma symptoms develop.
- Call your health care provider or go to the emergency room if:
- An asthma attack requires more medication than recommended
- Symptoms get worse or do not improve with treatment
- You have shortness of breath while talking
- Your peak flow measurement is 50-80% of your personal best
Go to the emergency room if:
- Drowsiness or confusion develops
- There is severe shortness of breath at rest
- The peak flow measurement is less than 50% of your personal best
- You have severe chest pain
Treatment options
The goal of treatment is to avoid the substances that trigger your symptoms and to control airway inflammation. You and your doctor should work together as a team to develop and carry out a plan for eliminating asthma triggers and monitoring symptoms. There are two basic kinds of medication for the treatment of asthma:
- Long-acting medications to prevent asthmatic attacks
- Quick-relief medications for use during asthmatic attacks
People with mild asthma (infrequent attacks) may use quick relief medication as needed. Those with persistent asthma should take control medications on a regular basis to prevent symptoms. A severe asthma attack requires a check up by a doctor and, possibly, a hospital stay, oxygen, and medications through a vein (IV). A peak flow meter is a simple device to measure how quickly you can move air out of your lungs. It can help you see if an attack is coming, sometimes even before any symptoms appear. Peak flow measurements can help show when medication is needed, or other action needs to be taken. Peak flow values of 50-80% of a specific person's best results are a sign of a moderate asthma attack, while values below 50% are a sign of a severe attack.
Long-term Control
Long-term control medications are used on a regular basis to prevent attacks, not to treat them.
Quick-relief Medications
Quick relief, or rescue, medications are used to relieve symptoms during an attack.
Asthma care at Home
Self-care skills that are important in taking care of your asthma are:
- Know the asthma symptoms to watch out for
- Know how to take your peak flow reading and what it means
- Keep the phone number of your child's doctor or nurse with you.
- Know which triggers make your asthma worse and what to do when this happens.
- Children with asthma need a lot of support at school. They may need help from school staff to keep their asthma under control and to be able to do school activities.
Resources
| Title | Region | Description | URL | Related Pages |
|---|---|---|---|---|
| Asthma by numbers | Australia | Snapshot of the latest statistics on asthma in Australia. | http://aihw.gov.au/asthma/ | Australian Institute of Health and Welfare (AIHW) |
| Chronic respiratory conditions publications | Australia | http://aihw.gov.au/chronic-respiratory-conditions-publications/ | Australian Institute of Health and Welfare (AIHW) |
- Dr Hervey Lau (Respiratory and Sleep Medicine Specialist)
- Dr Farhana Islam (GP)
- Dr Julie Belousoff (Paediatrician)
- Dr Aalia Thasneem Saleem (Respiratory and Sleep Medicine Specialist)
- Dr Lucy Burr (Respiratory and Sleep Medicine Specialist)
- Dr Terence Ting (Respiratory and Sleep Medicine Specialist)
- Dr Garrick Don (Respiratory and Sleep Medicine Specialist)
- Dr Carl Kennedy (Immunology and Allergy Specialist)
- Dr Gregory Katsoulotos (Respiratory and Sleep Medicine Specialist)
- Dr Farzad Bashirzadeh (Respiratory and Sleep Medicine Specialist)
- … further results
