Shortness of breath in bronchial asthma: nature, treatment

Shortness of breath in bronchial asthma can appear suddenly and has the ability to rapidly progress, creating a danger of asphyxia.
This condition is the most dangerous symptom of an acute disease of the bronchial-pulmonary system, with the development of which compulsory treatment is required.

Dyspnea in asthmatic syndrome can occur on expiration and is called expiratory or appear on inspiration (inspiratory). To determine the causes of dyspnea, it is necessary to clarify the etiology of the disease, since depending on this, the nature of dyspnea may also change.

Classification and nature of shortness of breath

The severity of shortness of breath directly depends on the severity of the symptoms and the prevalence of the process.

There are 2 forms of shortness of breath:

1. Inspiratory

In this case, the nature of shortness of breath is expressed by difficulty breathing and develops with reflex spasms of the vocal cracks, penetration of a foreign body into the respiratory tract, edema and tumor-like neoplasms of the trachea and larynx. In this form of the disease, breathing is called stridor (noisy).

2. Expiratory

This symptom occurs as a result of narrowing of the bronchial lumen and most often occurs in bronchial asthma. In the case when the disease takes on a chronic course, expiratory dyspnea is classified in several subspecies:

• temporary - this type of shortness of breath most often occurs in patients suffering from acute croupous pneumonia, in which the inflammatory process spreads over a large area of ​​the lung. This leads to the exclusion of a significant part of the lung from the respiratory process and poses a serious threat to the patient;

• constant - this type of disease is observed in the presence of chronic processes in the lungs (emphysema, etc.);
• obstructive - the nature of the violation of this type of dyspnea is closely interrelated with the ventilation function of the lungs, when an increased resistance to the movement of air causes a violation of the conductivity of the bronchi. The obstructive type of shortness of breath can appear at complete rest, characterized by a slow and difficult exhalation.

In the case of the addition of edema of the mucous membranes of the trachea and larynx, shortness of breath may be accompanied by a barking cough and a hoarse voice. If the nature and type of shortness of breath changes dramatically, expressed as cyanosis (blue nasolabial triangle), urgent treatment should be started due to the likelihood of developing obstruction in the airways.

The mechanism of development of shortness of breath

The type of asthmatic disease and symptoms depend on its nature. The cardiac form of asthma is expressed by insufficient activity of the cardiac system and appears as a result of disturbances in the functioning of the pulmonary artery. The result of these manifestations is inspiratory dyspnea.

Bronchial asthma occurs as a result of narrowing of the lumen in the bronchi. The nature of the narrowing depends on the edema of the mucous membrane in the lower part of the respiratory tract, in connection with which the secretion of sputum increases. It acquires a high viscosity and is hardly removed to the outside. This results in expiratory dyspnea.

In asthmatic bronchial disease, the type of shortness of breath is characterized by a short, light breath and a noisy, difficult exhalation. However, with drug therapy aimed at expanding the bronchi, respiratory activity quickly normalizes.

A choking attack may occur after contact with allergens. With a severe course of the disease, the attack cannot be stopped with the help of bronchomimetics, as a result of which loss of consciousness occurs. An allergic type of asthma is most dangerous for a patient in which emergency treatment is required.

Symptoms of the disease

Shortness of breath, as an independent symptom, can be accompanied by other manifestations, among which the most often noted are:

subfebrile (38 ° C - 38.5 ° C) body temperature, which can rise sharply to high levels;

• increased fatigue;
• the patient's appearance is apathetic;
• rapid fatigue and weakness;

• increased sweating;
• dry cough or, conversely, with profuse phlegm;
• tingling pain in the chest.

In addition, general symptoms of intoxication are characteristic.

Danger of shortness of breath

Shortness of breath, as an independent phenomenon, cannot threaten the patient's body, since it refers to the external manifestations of bronchial obstruction. Moreover, its treatment requires the use of special anti-asthma drugs, which quickly relieve both shortness of breath and bronchial symptoms provoked by the disease.

It is much worse when the nature and type of shortness of breath increases against the background of the treatment, causing severe suffocation. Such symptoms indicate the transition of an asthma attack to status asthmaticus. As a rule, with the usual development of an attack, the treatment of obstructive phenomena is quickly stopped by short-acting drugs (Salbutamol, Fenoterol, etc.).

As a result of status asthmaticus, a short-term improvement in the patient's condition is determined, but shortness of breath, despite treatment with inhalers, cannot be completely neutralized. After a few hours, the attack may recur and be more severe.

Status asthma is a life-threatening condition that can occur as a result of contact with allergens, with the sudden cancellation of glucocorticosteroid anti-asthma drugs. The nature of the asthmatic status may change as a result of an overdose of inhaled adrenergic agonist.

With the development of an asthmatic attack, there is an increase in the blockage of the bronchial ducts, the nature of respiratory disorders can be expressed by the cyanosis of the skin, especially the nasolabial triangle. In addition, the face becomes pasty, the heart rate increases, and a sharp rise in blood pressure is observed. In the future, shortness of breath turns into shallow breathing, which is not able to saturate the body with oxygen to the fullest. Blood pressure drops sharply and there may be loss of consciousness to a complete coma, which leads to disruption of body functions and, as a result, to death.

In order to effectively treat shortness of breath, it is necessary to understand what causes this type of symptomatology. It is important to find out what kind of disease triggered its occurrence. Quality treatment is impossible without finding out the reasons. In addition, improperly performed therapeutic measures as a result of an undetected cause of shortness of breath can cause irreparable harm to the patient.

Treatment activities

Drug therapy should be prescribed only by highly qualified specialists (therapist, pulmonologist, infectious disease specialist, cardiologist, etc.). In addition, treatment with alternative methods is not recommended, as they may be ineffective.

When a bronchial attack begins, the recommended actions should be followed:

• before the arrival of the medical team, the patient should be provided with fresh air by opening or opening the window. You can relax tight clothes and give the patient the most comfortable position;

• treatment of bronchial asthma requires lifelong medication. Sometimes hormonal preparations containing glucocorticosteroids can be prescribed;
• if the bronchial attack is of an asthmatic type, in the absence of inhalers, etc. intravenous administration of 2, 4% solution of Euphyllin is prescribed. The drug should be administered very slowly.

It is recommended to start treatment of asthmatic disease with the introduction of metered inhalations of selective beta-adrenomimetics of the shortest possible exposure (Salbutamol, Berotek, etc.).

This requires compliance with certain rules:

1. It is not recommended to do more than two "injections" in a row. It is necessary to make a break of at least 20 minutes between inhalations. More frequent use of aerosols will not lead to a positive effect, and side effects may worsen, expressed as a rapid heart rate, changes in blood pressure, etc.
2. If the pattern of shortness of breath changes, you should not wait for the onset of a severe attack and the associated risk. Appropriate action must be taken immediately.

1. It is not recommended to exceed the daily dosage of the inhaler. Continuous use should not exceed 6-8 breaths. More frequent use of the inhaler for persistent choking can be dangerous. This condition can develop into status asthmaticus, which is quite difficult to stop even with the help of intensive therapy.

The main condition is the timely prevention of various complications. To do this, it is recommended to seek help from highly qualified specialists and not to self-medicate, wasting precious time. Only an integrated approach and regular medical examinations contribute to the maximum preservation of health and the prevention of patient disability.