Asthma is a chronic lung disease that typically begins in childhood. People with asthma have inflamed airways. “Triggers” like inhaled substances, excessive cold, air pollution, and even exercise can cause the airways to narrow because the chronic inflammation makes them very sensitive. The muscles around the airways tighten, restricting air flow. In some patients thick, sticky mucus can also narrow the airways further.
A chronic cough and respiratory difficulties are the hallmark signs of asthma. The cough is more likely to occur at night or early in the morning. It is often dry (although not always) and can range from mild to severe. Wheezing is a common asthma symptom and results from the narrowing airways. People with asthma may breathe more quickly than normal, or breathe through the mouth to try and get air. When the symptoms increase the patient is having an asthma exacerbation or asthma attack.
Treatment for asthma falls into two categories: maintenance and treatment of exacerbation, or asthma attacks. Medications include bronchodilators, which help expand the narrowed airways, and inhaled steroids, which treat the inflammation. Other measures are often helpful such as identifying and avoiding triggers, or dealing with any allergies. For example, dust and smoke can make asthma worse and should be avoided if possible. An asthma attack is a much more serious situation and is treated with inhaled medications, adrenalin, and oxygen.
It's important to recognize a slight exacerbation (increased shortness of breath, more coughing and wheezing). If the symptoms don't respond to inhaled medications, an urgent care visit is a good idea. However, if the patient is too short of breath to speak or fingernails and lips are blue, immediate emergency care is needed. An exacerbation of these symptoms can be life-threatening and should be treated in an emergency room.
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