Asthma Attacks

What is asthma?
Asthma is a chronic, inflammatory disease in which the airways become sensitive to
allergens (any substance that triggers an allergic reaction). Several things happen
to the airways when a person is exposed to certain triggers:
The lining of the airways become swollen and inflamed.
The muscles that surround the airways tighten.
The production of mucus in increased, leading to mucus plugs.
All of these factors will cause the airways to narrow, thus making it difficult for air to
go in and out of your lungs, causing the symptoms of asthma.
What are the symptoms of asthma?
Asthma may resemble other respiratory problems such as emphysema, bronchitis,
and lower respiratory infections. It is often under-diagnosed and many people with
the disease do not know they have it. Sometimes, the only symptom is a chronic
cough, especially at night, or coughing or wheezing that occurs only with exercise.
Some people think they have recurrent bronchitis, since respiratory infections
usually settle in the chest in a person predisposed to asthma.
What causes asthma?
The exact cause of asthma is not completely known. It is believed to be partially
inherited, but it also involves many other environmental, infectious, and chemical
factors.
After a person is exposed to a certain trigger, the body releases histamine and other
agents that can cause inflammation in the airways. The body also releases other
factors that can cause the muscles of the airways to tighten, or become smaller.
There is also an increase in mucus production that may clog the airways.
Some persons have exercise-induced asthma, which is caused by varying degrees of
exercise. Symptoms can occur during, or shortly after, exercise. Each person has
different triggers that cause the asthma to worsen. You should discuss this with your
physician.
The changes that occur in asthma are believed to happen in two phases:
An immediate response to the trigger leads to swelling and narrowing of the
airways. This makes it initially difficult to breathe.
A later response, which can happen four to eight hours after the initial exposure to
the allergen, leads to further inflammation of the airways and obstruction of airflow.
Knowing your risk factors to any disease can help to guide you into the appropriate
actions, including changing behaviors and being clinically monitored for the disease.
What are the risk factors for an asthma attack?

Although anyone may have an asthma attack, it most commonly occurs in the
following persons:
children by the age of 5
adults in their 30s
adults older than 65
people living in urban communities
Other factors include the following:
family history of asthma
personal medical history of allergies
Children most susceptible to asthma attacks include the following:
children with a family history of asthma
children who have allergies
children who have exposure to secondhand tobacco smoke
What happens during an asthma attack or asthma exacerbation?
Persons with asthma have acute episodes when the air passages in their lungs
become narrower, and breathing becomes more difficult. These problems are
caused by an over-sensitivity of the lungs and airways.
The lungs and airways overreact to certain triggers causing:
the lining of the airways to become inflamed and swollen.
tightening of the muscles that surround the airways.
an increased production of mucus.
Breathing becomes harder and may hurt.
There may be coughing.
There may be a wheezing or whistling sound, which is typical of asthma. Wheezing
occurs because of the rush of air which moves through the narrowed airways.
How is asthma diagnosed?
To diagnose asthma and distinguish it from other lung disorders, physicians rely on
a combination of medical history, physical examination, and laboratory tests, which
may include the following:
spirometry - a spirometer is a device used by your physician that assesses lung
function. Spirometry, the evaluation of lung function with a spirometer, is one of the

simplest, most common pulmonary function tests and may be necessary for any/all
of the following reasons:
to determine how well the lungs receive, hold, and utilize air
to monitor a lung disease
to monitor the effectiveness of treatment
to determine the severity of a lung disease
to determine whether the lung disease is restrictive (decreased airflow) or
obstructive (disruption of airflow)
peak flow monitoring (PFM) - a device used to measure the fastest speed in which a
person can blow air out of the lungs. During an asthma or other respiratory flare up,
the large airways in the lungs slowly begin to narrow. This will slow the speed of air
leaving the lungs and can be measured by a PFM. This measurement is very
important in evaluating how well or how poorly the disease is being controlled.
chest x-rays - a diagnostic test which uses invisible electromagnetic energy beams
to produce images of internal tissues, bones, and organs onto film.
blood tests - to analyze the amount of carbon dioxide and oxygen in the blood.
allergy tests
What are the triggers that can cause an asthma attack?
According to the National Institute for Allergy and Infectious Diseases, the American
Academy of Allergy, Asthma, and Immunology, and other organizations, triggers for
asthma include the following:
Allergens

Respiratory Infections and Sinusitis

pollen

Infections can cause irritation of the

airways, nose, throat, lungs, and sinuses,
and worsens asthma.

mold
animal protein (dander, urine, oil from
skin)
house dust/dust mites
cockroaches
certain foods
Irritants

Sensitivity to Medications

strong odors and sprays, such as

perfumes, household cleaners, cooking
fumes, paints, and varnishes

Medications, such as aspirin and sulfites,

cause up to 20 percent of adult
asthmatic attacks as a result of
sensitivities or allergies to them. These

chemicals such as coal, chalk dust, or

talcum powder
air pollutants
changing weather conditions, including
changes in temperature, barometric
pressure, humidity, and strong winds
Chemical-exposure on the job, such as
occupational vapors, dust, gases, or
fumes.

medications often include:

aspirin
other non-steroidal anti-inflammatory
medications, such as ibuprofen,
indomethacin, naproxen
sulfites used as preservatives in food and
beverage
Before taking any medication, including
over-the-counter medications, consult
your physician.

Exercise

Gastroesophageal reflux

Exercise can trigger an asthma attack,

often because of the inhaled cool and dry
air. Long-term strenuous activities such
as long distance running, are most likely
to induce asthma, and swimming is the
least likely.

GERD, a condition characterized by

persistent reflux of stomach acids, is
common in individuals with asthma.
Symptoms may include heartburn,
belching, or spitting up in infants.

Smoke

Emotional Anxiety and Nervous Stress

Tobacco smoke, whether directly or

passively inhaled, has been shown to
worsen asthma.

Reactions from stress and anxiety are

considered to be more of an effect than a
cause. They can cause fatigue, which
may affect the immune system and, in
Wood smoke from wood-burning heating turn, increase either asthma symptoms
stoves and fireplaces can
or bring on an attack.
release irritating chemicals such as sulfur
dioxide.