Asthma affects 7% of all Americans. Medications used to treat asthma are divided into two general classes: quick-relief medications used to treat acute symptoms and long-term control medications used to prevent further exacerbation. People with asthma should avoid all triggers, ie.:Reduce exposure to allergens to which the person is sensitive; Avoid exposure to environmental tobacco smoke, smoke from wood-burning stoves and fireplaces, and substances with strong odors; Avoid exertion outdoors when levels of air pollution are high; Avoid use of nonselective beta-blockers; Avoid sulfite-containing and other foods to which they are sensitive; Consider allergen immunotherapy when there is clear evidence of a relationship. For those in whom exercise can trigger an asthma attack, higher levels of ventilation and cold, dry air tend to exacerbate attacks. For this reason, activities in which a patient breathes large amounts of cold air, such as skiing and running, tend to be worse for people with asthma, whereas swimming in an indoor, heated pool with warm, humid air is less likely to provoke a response.
An acute exacerbation of asthma is commonly referred to as an asthma attack. The cardinal symptoms of an attack are shortness of breath (dyspnea), wheezing, and chest tightness. Although the former is often regarded as the primary symptom of asthma, some people present primarily with coughing, and in the late stages of an attack, air motion may be so impaired that no wheezing is heard. When present the cough may sometimes produce clear sputum. The onset may be sudden, with a sense of constriction in the chest, as breathing becomes difficult and wheezing occurs (primarily upon expiration, but sometimes in both respiratory phases). It is important to note inspiratory stridor without expiratory wheeze however, as an upper airway obstruction may manifest with symptoms similar to an acute exacerbation of asthma, with stridor instead of wheezing, and will remain unresponsive to bronchodilators. Signs of an asthmatic episode include wheezing, prolonged expiration, a rapid heart rate (tachycardia), and rhonchous lung sounds (audible through a stethoscope). The affected patient may also appear pale. During a serious asthma attack, the accessory muscles of respiration (sternocleidomastoid and scalene muscles of the neck) may be used and there may be the presence of a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest.
During very severe attacks, an asthma sufferer’s face and fingernails can turn blue from lack of oxygen, and can experience chest pain or even loss of consciousness. A patient’s fingernails may also turn purple due to a lack, or low amount of oxygen circulating through the bloodstream. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs and palms may start to sweat. The person’s feet may become cold. Severe asthma attacks which are not responsive to standard treatments, called status asthmaticus, are life-threatening and may lead to respiratory arrest and death.
Though symptoms may be very severe during an acute exacerbation, between attacks a patient may show few or even no signs of the disease.
If you think you have asthma and would like to be accurately diagnosed, please contact Med-Cure Primary Care Physicians in Houston, TX, Rosenberg, TX, and Sugar Land, TX.