Asthma: Causes, Symptoms, Types, Diagnosis & Treatment

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Asthma is a chronic inflammatory disease of the airways characterized by variable airflow obstruction, bronchial hyperresponsiveness, and recurrent respiratory symptoms. It is a major global health concern affecting both children and adults.

This post serves as a complete reference for medical students, healthcare learners, and general readers, covering asthma pathophysiology, clinical features, diagnosis, treatment, prevention, and long-term management.

What Is Asthma? (Medical Definition)

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by a history of respiratory symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and in intensity, along with variable expiratory airflow limitation.

Pathophysiology of Asthma (For Medical Students)

The underlying mechanisms of asthma involve:

  • Chronic airway inflammation

  • Bronchial smooth muscle hypertrophy

  • Increased mucus secretion

  • Airway hyperresponsiveness

Key Cellular Players:

  • Mast cells

  • Eosinophils

  • T lymphocytes (Th2 cells)

  • Cytokines (IL-4, IL-5, IL-13)

These lead to bronchoconstriction, airway edema, and mucus plugging, resulting in airflow obstruction.

👉 Read the complete pathophysiology here:

Causes and Risk Factors of Asthma

Genetic Factors

  • Family history of asthma or atopy

  • Genetic predisposition to IgE-mediated responses

Environmental Factors

  • Allergens (dust mites, pollen, mold, pet dander)

  • Air pollution and tobacco smoke

  • Occupational exposures

  • Viral respiratory infections

Clinical Features and Symptoms of Asthma

Common Symptoms

  • Episodic wheezing

  • Dyspnea

  • Chest tightness

  • Nocturnal or early morning cough

Signs During Acute Exacerbation

  • Tachypnea

  • Use of accessory muscles

  • Reduced peak expiratory flow rate (PEFR)

  • Hypoxemia in severe cases

Types of Asthma (Classification)

Based on Triggers

  • Allergic (Atopic) Asthma

  • Non-Allergic Asthma

  • Exercise-Induced Bronchoconstriction

  • Occupational Asthma

Based on Age

  • Childhood-onset asthma

  • Adult-onset asthma

Based on Severity

  • Intermittent

  • Mild persistent

  • Moderate persistent

  • Severe persistent

👉 Read the complete pathophysiology here:

Diagnosis of Asthma (Clinical + Investigations)

Diagnostic Criteria

  • History of variable respiratory symptoms

  • Demonstration of reversible airflow limitation

Investigations

  • Spirometry (FEV₁ improvement ≥12% post-bronchodilator)

  • Peak Expiratory Flow (PEF) variability

  • Bronchoprovocation tests (methacholine challenge)

  • Allergy testing (IgE levels, skin prick test)

Differential Diagnosis of Asthma (Important for Exams)

  • COPD

  • Bronchitis

  • Vocal cord dysfunction

  • Heart failure (cardiac asthma)

  • Pulmonary embolism

Management and Treatment of Asthma

Pharmacological Management

Reliever Medications

  • Short-acting β₂ agonists (SABA)

Controller Medications

  • Inhaled corticosteroids (ICS)

  • Long-acting β₂ agonists (LABA)

  • Leukotriene receptor antagonists

  • Biologic agents (omalizumab, mepolizumab)

Stepwise Management (GINA Guidelines)

Treatment is adjusted based on asthma severity and control.

Asthma Exacerbation (Attack) – First Aid & Emergency Care

Acute Management

  • High-flow oxygen

  • Nebulized SABA

  • Systemic corticosteroids

  • Magnesium sulfate (severe cases)

Non-Pharmacological Management

  • Trigger avoidance

  • Smoking cessation

  • Patient education

  • Asthma action plan

  • Regular monitoring of lung function

Prevention and Long-Term Control

Asthma control focuses on:

  • Reducing symptom frequency

  • Preventing exacerbations

  • Maintaining normal lung function

  • Improving quality of life

Complications of Uncontrolled Asthma

  • Status asthmaticus

  • Airway remodeling

  • Reduced lung capacity

  • Increased mortality risk

Living With Asthma: Prognosis and Quality of Life

With appropriate management, most asthma patients can live normal, productive lives. Early diagnosis, adherence to treatment, and education are key.


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