It is characterized by the chronic airway inflammation and increased airway hyper responsiveness leading to triad of symptoms (wheeze, chest tightness, and dyspnea). Asthma is a common disease and has a range of severity from a very mild, occasional wheeze to acute life-threatening airway closure.
Triggers/Risk factors: Viral respiratory tract infections, Exercise , Occupational exposure , Chronic sinusitis , Environmental allergens , Use of aspirin, beta-blockers ,Tobacco smoke , Insects, plants, chemical fumes , Obesity , Emotional factors or stress , Duration and Intensity of such exposure or allergens determine the possibility of occurring of asthma.
The pathological process begins with the inhalation of an irritant (e.g., cold air) or an allergen (e.g., pollen), which then, due to bronchial hypersensitivity, leads to airway inflammation and an increase in mucus production. The tendency of airways to contract too easily too much in response to trigger that have little or no effect in normal individuals. This leads to a significant increase in airway resistance, which is most pronounced on expiration.
CLINICAL FEATURES: Wheezing, Coughing, Chest tightness, Dyspnea ,
DIAGNOSIS: Spirometry –
Fev1 >15% increase following administration of bronchodilator
Fev1>15% decrease after 6 minutes of exercise.
Measurement of allergic status by skin prick test.
Assessment no eosinophilic airway inflammation.
Peak expiratory flow meter rate before and after inhalation of B2 adrenoreceptor agonist.
Radiological finding- hyperinflation of airways, mucus occlusion a large bronchus.
TREATMENT: Patient Education, Avoidance of aggravating Factors, Stepwise approach to medication specially CORTICOSTEROIDS.
Add on physiotherapy – To increase the dosage in patients if patient remains poorly controlled despite regular use of corticosteroids e.g. Chest tapping