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Clinical use of nebulisers Asthma (demo)Definitions and symptoms Using spirometry to evaluate lung function DefinitionThe diagnosis of asthma is a clinical one, however it is not always simple. For such a common disease making the diagnosis is not helped by the lack of agreement over the precise definition of what asthma is. In an international consensus report, it has been described as: 'A chronic inflammatory disorder of the airways in susceptible individuals, where inflammatory symptoms are usually associated with widespread but variable airflow obstruction and an increase in airway response to a variety of different stimuli. Obstruction is often reversible either spontaneously or with treatment'. SymptomsIt is important to remember that people with asthma may suffer from a variety of symptoms, none of which is actually specific for asthma. The symptoms include:wheeze, shortness of breath, chest tightness and cough. In asthma these symptoms tend to be: variable, intermittent, worse at night and provoked by triggers such as exercise. The cases below show patients with asthma. The first shows a young child admitted with an acute attack in respiratory distress. The second, an older child with shortness of breath with simple exercise and the third shows an adult with expiratory wheeze. Case 1 This 3 and a half year old boy with a history of asthma presented with a moderately severe asthma attack shortly after the onset of a mild upper respiratory tract infection. He has an oxygen saturation of 90% and is tachycardic. He also has marked sternal recession in drawing at the level of his diaphragm and intercostal recession. His is tachypnoiec and has an expiratory wheeze. When he is sitting up, his recession is even more noticable at the insertion of his diaphragm into his lower rib case. There is marked suprasternal recession and wheeze is heard on auscultation. Case 2 This video shows a young boy who has quite marked exercise induced asthma. You can see that following simple exercise he gets very short of breath. Case 3 This video shows a middle aged woman with an exacerbation of asthma. She has a loud audible wheeze and on auscultation has diffused predominately expiratory polyphonic wheeze. NB: not all that wheezes is asthmaSome of the symptoms of asthma may be shared by other diseases, so it is important always to have an open mind with regards to the diagnosis and not to ignore other possibilities. |
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© 2007 OCB MEDIA |  |
