Asthma: Overview, Diagnosis, Signs and Symptoms and Treatment
What is Asthma?
Asthma is a chronic, obstructive, respiratory condition that causes inflammation and narrowing of the airways in the lungs. This leads to recurring episodes of dyspnea and wheezing.
It varies with different levels of severity, and an episode can occur due to certain triggers and other causes.
Causes
The causes of asthma involve a combination of genetic and environmental factors. Some examples of the most common asthma triggers include:
- Pollen
- Dust
- Grass
- Animal fur
- Cold air
- Exercise
- Stress
- Cigarette smoke
- Respiratory infections
Each patient is different; therefore, each patient may experience an asthma episode due to different triggers.
Signs and Symptoms
Asthma can cause several signs and symptoms, including the following:
- Dyspnea
- Wheezing
- Coughing
- Shortness of breath
- Pursed-lip breathing
- Chest tightness
- Increased A-P diameter of the chest
- Increased accessory muscle usage while breathing
- Hyperresonant chest percussion note
- Diaphoresis
- Diminished breath sounds (during a severe episode)
The patient’s vital signs may show signs of tachycardia, tachypnea, and pulsus paradoxes. Again, each patient may experience different signs and symptoms depending on the severity of their condition.
Diagnosis
There are several methods and diagnostic tests that are useful in the diagnosis of asthma. Some examples include:
- Medical history
- Physical examination
- Laboratory tests
- Arterial blood gas
- Chest radiograph
- Pulmonary function testing
- Pre/post-bronchodilator study
The patient’s ABG results will likely initially show signs of acute alveolar hyperinflation with hypoxemia. If their condition worsens, hypercarbia and respiratory failure can occur.
The chest x-ray of a patient with asthma would show an increased A-P diameter, dark (translucent) lung fields, and flattened diaphragms.
The patient’s PFT results would show decreased flow rates. If there is a significant improvement in the patient’s FEV1 of more that 12% after receiving a bronchodilator, this is an indication that asthma is present.
Treatment
The goals of treatment for asthma are to relieve symptoms, prevent exacerbations, and improve the patient’s quality of life. The most common treatment methods include:
- Oxygen therapy
- Bronchodilators
- Corticosteroids
- Leukotriene modifiers
- Theophylline
- Immunotherapy
As a respiratory therapist, it’s important to monitor patients close during an acute episode. Adjunct therapies may be necessary in some cases, such as heliox, magnesium sulfate, or subcutaneous epinephrine
In severe cases, intubation and mechanical ventilation may be indicated for the treatment of respiratory failure.
Management
The long-term management of asthma symptoms is important in order to prevent acute exacerbations and improve the patient’s quality of life.
This involves eliminating or minimizing the triggers that can cause an acute episode.
The patient may also require the use of controller medications such as long-acting beta-agonists, inhaled corticosteroids, mast cell stabilizers, and leukotriene inhibitors.
Final Thoughts
Asthma is a chronic inflammatory disease of the airways characterized by hyperresponsiveness and inflammation. The specific causes include combination of genetic and environmental factors.
Respiratory therapists are involves in the diagnosis, treatment, and management of asthmatic patients. Their role is especially important during an acute exacerbation.
If you found this information helps, be sure to check out our similar guides on COPD and the other obstructive lung diseases. Thanks for reading!
