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Bronchial asthma
What is bronchial asthma?
Bronchial asthma is an obstructive airway disease characterised by reversible airflow obstruction, bronchial hyperreactivity, and inflammation. This condition leads to dyspnoea and wheezing. Bronchial asthma may disrupts daily activities and may result in a life-threatening situation such as asthma exacerbation, where the airways become more swollen and inflamed. Although bronchial asthma cannot be cured, its symptoms are manageable. Because asthma frequently changes over time, it is critical for an asthmatic patient to collaborate with the physician in monitoring its signs and symptoms with a suitable treatment as needed.
What causes an asthma exacerbation or an asthma attack?
An acute exacerbation of asthma is referred to as an asthmatic attack. The asthma episodes may be triggered by exposure to environmental stimulants such as allergens, tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, or emotional stress. During the attack, the muscles around the airways are constricted and the airways produce more mucous, causing the bronchial tubes to narrow.
What is the aetiology of bronchial asthma?
Bronchial asthma is a group of diseases that have a wide range of phenotypes. A genetic predisposition, specifically a personal or family history of atopy, is one of the recognised risk factors for bronchial asthma (propensity to allergy, usually seen as
eczema, hay fever, and bronchial asthma). Exposure to tobacco smoke and other inflammatory gases or particles has also been
linked to bronchial asthma. The overall aetiology is complex and still not fully understood, particularly when it comes to predicting which children with paediatric asthma will develop bronchial asthma during adulthood.
What are the signs and symptoms of bronchial asthma?
Signs of asthmatic episodes include wheezing, prolonged expiration, tachycardia, rhonchus lung sounds (audible through a stethoscope), the presence of a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation) and over-inflation of the chest (barrel chest). During a serious asthmatic attack, the accessory muscles of respiration (sternocleidomastoid and scalene muscle of the neck) may be used. This is shown as in-drawing of tissues between the ribs and above the sternum and clavicles.
How bronchial asthma is treated?
It is important for an asthmatic patient to take medication exactly as prescribed by the physician to control it and to avoid any activities/things that can trigger an attack. Asthma medications are classified into two types: those that provide immediate relief and those that provide long-term control. Asthma attack symptoms are controlled by quick-relief medications, such as bronchodilators or long-term control medications, such an anti-inflammatory agents. Additionally, an asthmatic patient must be understanding the nature of bronchial asthma and aware of possible aggravating factors.
References
Reddel HK, Bacharier LB, Bateman ED, Brightling CE, Brusselle GG, Buhl R, et al.
Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for
Key Changes. Am J Respir Crit Care Med. 2022;205(1):17-35.
He Z, Feng J, Xia J, Wu Q, Yang H, Ma Q. Frequency of Signs and Symptoms in
Persons With Asthma. Respir Care. 2020;65(2):252-64.
Bush A. Pathophysiological Mechanisms of Asthma. Front Pediatr. 2019;7:68.
Written by :
Nurhusna Binti Shamsuddin Azmi
First Year Nursing Student
Universiti Kebangsaan Malaysia
Reviewed by :
Pn. Noor Wahidah Mohd Nasri
Lecturer
Department of Physiology
Faculty of Medicine
Hospital Canselor Tuanku Muhriz
Universiti Kebangsaan Malaysia
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