Asthma is a reversible lung disorder characterized by airway spasm, obstruction, and inflammation. Severity is highly unpredictable, ranging from mild illness to death. There is no predilection for age, sex, or race. Proper control of asthma requires prompt recognition of illness, excellent communication between physician and patient, and intense education.
There are three principal triggers for exacerbations:
1. Allergens These include inhaled substances, such as molds, pollens, dust, animal danders, cosmetics, and tobacco smoke; food additives that contain tartrazine coloring or sulfiting agents; and medications, especially beta-blockers and aspirin. Both selective agents and optical preparations of beta-blockers can aggravate asthma or cause death.
2. Infections Viral upper respiratory infections (URIs) are particularly problematic. In children it is common for episodes to follow URIs.
3. Psychological factors These can play a significant role and are often not readily recognized.
Symptoms
a. Typical presentation includes dyspnea, cough, and wheezing in a range of mild to severe with onset over minutes or days.
b. Atypical presentation. Some patients may be so tight that the usual triad of symptoms may appear only after initial treatment. At the other end of the spectrum, asthma may manifest only by chronic cough. A persistent night cough is often the only symptom of asthma in children.
c. Exercised-induced asthma (EIA) or bronchospasm is a variant in which symptoms are seen only following exercise.