Asthma

Definition

Asthma is a disease that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness, and coughing.

Alternative Names

Bronchial asthma

Causes

Asthma is caused by inflammation (swelling) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway.

In persons who have sensitive airways, asthma symptoms can be triggered by breathing in  substances called allergens or triggers.

Common asthma triggers include:

Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.

Symptoms

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 blocked.

Symptoms include:

Emergency symptoms that need prompt medical help:

Other symptoms that may occur:

Exams and Tests

The doctor or nurse will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard.

Tests that may be ordered include:

Treatment

The goals of treatment are:

You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms.

MEDICINES FOR ASTHMA 

There are two kinds of medicines for treating asthma:

Long-term Medicines

These are also called maintenance or controller medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK.

Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (oral). Your doctor will prescribe the right medicine for you.

Quick-relief Medicines

These are also called rescue medicines. They are taken for:

Quick-relief medicines include:

A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medications given through a vein (IV).

ASTHMA CARE AT HOME

Asthma action plans are written documents for managing asthma. An asthma action plan should include:

A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.

Outlook (Prognosis)

There is no cure for asthma, although symptoms sometimes improve over time. With proper self-management and medical treatment, most people with asthma can lead normal lives.

The complications of asthma can be severe, and may include:

  • Death
  • Decreased ability to exercise and take part in other activities
  • Lack of sleep due to nighttime symptoms
  • Permanent changes in the function of the lungs
  • Persistent cough
  • Trouble breathing that requires breathing assistance (ventilator)

When to Contact a Medical Professional

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:

Go to the emergency room if these symptoms occur:

Prevention

You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways.

References

Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic rhinitis and its impact on asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126:466-76.

Lugogo N, Que LG, Fertel D, Kraft M. Asthma. In: Mason RJ, Broaddus VC, Martin TR, et al., eds. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa.: Elsevier Saunders; 2010:chap 38.

National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Rockville, MD. National Heart, Lung, and Blood Institute, US Dept of Health and Human Services; 2007. NIH publication 08-4051. Available at http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed June 7, 2013.

Nowak RM, Tokarski GF. Asthma. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Elsevier Mosby; 2009:chap 71.