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Asthma
Attacks and Symptoms
An acute exacerbation of asthma is
referred to colloquially as an asthma attack. The clinical
hallmarks of an attack are shortness of breath (dyspnea) and wheezing,
the latter "often being regarded as the sine qua non."
A cough—sometimes producing clear
sputum—may also be present. The onset is often sudden; there is a "sense
of constriction" in the chest, breathing becomes difficult, and wheezing
occurs (primarily upon expiration, but can be in both respiratory
phases).
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Asthma Attacks cont..
Signs of an asthmatic
episode are wheezing, rapid breathing (tachypnea), prolonged expiration,
a rapid heart rate (tachycardia), rhonchous lung sounds (audible through
a stethoscope), and over-inflation of the chest.
During a serious asthma attack,
the accessory muscles of respiration (sternocleidomastoid and scalene
muscles of the neck) may be used, shown as in-drawing of tissues between
the ribs and above the sternum and clavicles, and the presence of a
paradoxical pulse (a pulse that is weaker during inhalation and stronger
during exhalation).
During very severe asthma attacks,
an asthma sufferer can turn blue from lack of oxygen, and can experience
chest pain or even loss of consciousness. Severe asthma attacks
may lead to respiratory arrest and death. Despite the severity of
symptoms during an asthmatic episode, between attacks an asthmatic may
show few signs of the disease.
In most cases, a physician can diagnose asthma on the basis of
typical findings in a patient's clinical history and examination. Asthma
is strongly suspected if a patient suffers from eczema or other allergic
conditions—suggesting a general atopic constitution—or has a family
history of asthma.
While measurement of airway function is
possible for adults, most new asthma cases are diagnosed in children who
are unable to perform such tests. Asthma diagnosis in children is
based on a careful compilation and analysis of the patient's medical
history and subsequent improvement with an inhaled bronchodilator
medication. In adults, diagnosis can be made with a peak flow meter
(which tests airway restriction), looking at both the diurnal variation
and any reversibility following inhaled bronchodilator medication.
Testing peak flow at rest (or baseline) and after exercise can be
helpful, especially in young asthmatics who may experience only
exercise-induced asthma. If the diagnosis is in doubt, a more formal
lung function test may be conducted. Once a diagnosis of asthma
is made, a patient can use peak flow meter testing to monitor the
severity of the disease.
Asthma Information
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