Symptoms of bronchial asthma

In the development of an attack of bronchial asthma, three periods are distinguished - precursors, peak (suffocation) and reverse development.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Symptoms of the period of suffocation of bronchial asthma

The peak period (suffocation) has the following symptoms. There is a feeling of shortness of breath, chest tightness, pronounced expiratory dyspnea. Inhalation becomes short, exhalation is slow, 2-4 times longer than inhalation, accompanied by loud, prolonged, wheezing, audible at a distance. The patient takes a forced position, sits, leaning forward, resting his elbows on his knees, or leaning his hands on the edge of a table, bed, catching air with his mouth. Speech is almost impossible, the patient is worried, frightened. The face is pale, with a bluish tint, covered with cold sweat. The wings of the nose swell when inhaling. The chest is in the position of maximum inspiration, the muscles of the shoulder girdle, back, abdominal wall participate in breathing.

The intercostal spaces and supraclavicular fossa are drawn in during inspiration. The jugular veins are swollen. During an attack, a cough with very difficult to separate viscous, thick sputum is observed. After the sputum is released, breathing becomes easier. Above the lungs, a percussion sound with a tympanic tint is heard, the lower borders of the lungs are lowered, the mobility of the pulmonary edges is limited, against the background of weakened breathing during inspiration and especially during expiration, many dry wheezing rales are heard. The pulse is rapid, weak in filling, the heart tones are muffled. An attack of suffocation can develop into asthmatic status, which can end in a coma and even death of the patient.

Symptoms of reversal of an attack

The period of reverse development of the attack has different duration. In some patients the attack ends quickly without complications, in others it can last for several hours and even days with the persistence of difficult breathing, malaise, weakness. After the attack, patients want to rest, some of them feel hungry and thirsty.

Cough variant asthma

When analyzing the clinical picture of bronchial asthma, one should remember the so-called cough variant of the disease. With this form of bronchial asthma, there is no typical clinical picture of an asthma attack, and dry wheezing is absent or very scanty physical signs are determined during auscultation of the lungs. The only characteristic sign of the disease is a paroxysmal suffocating cough, especially often occurring at night. During a coughing attack, dizziness may occur, sweating is observed, and cyanosis of the face is possible. To diagnose the cough variant of bronchial asthma, peak expiratory flow rate should be monitored, and the positive effect of evening (prophylactic) intake of bronchodilators should be taken into account.

Determining the severity of an asthma attack is of great importance. This is taken into account when providing assistance to the patient and determining his ability to work.

[ 5 ], [ 6 ], [ 7 ], [ 8 ], [ 9 ]

Signs of the precursor period

The precursor period begins several minutes, hours, sometimes days before the attack and is manifested by the following symptoms: vasomotor reactions of the nasal mucosa (abundant secretion of watery mucus), sneezing, itching of the eyes and skin, paroxysmal coughing, shortness of breath, headache, fatigue, excessive diuresis, and often mood changes (irritability, mental depression, gloomy forebodings).