Bronchial asthma is a chronic inflammatory disease of the respiratory tract, manifested by bronchial hyperactivity, bronchial obstruction as a result of bronchospasm, edema of the bronchial mucosa and hypersecretion.
A choking attack in atopic bronchial asthma occurs with the direct effects of a causally significant allergen. In other cases, the occurrence and development of bronchial asthma are involved:
- infectious agents (viral, bacterial, fungal, parasitic);
- drugs (penicillin drugs, nonsteroid anti-inflammatory drugs);
- physical loading and some other factors.
The main symptom of bronchial asthma is a choking attack with a difficult exhalation, which occurs mainly in the night and morning hours. It is accompanied by distant wheezing. The main symptoms of bronchial asthma are:
- asthma and paroxysmal cough;
- labored breathing;
- wheezing, noisy breathing;
- secretions when coughing viscous sputum at the final stage of asphyxiation;
- a combination with allergic rhinitis and conjunctivitis, pathology of the upper respiratory tract;
- nasal polyposis (in the case of aspirin-induced asthma);
The symptoms of asthmatic status are:
- scanty viscous secretion;
- wheezing, a sharp weakening of the breath;
- in severe cases – “dumb heart” (complete absence of wheezing and bronchial conduction);
- paradoxical pulse.
The following complications of asthma are distinguished:
- pulmonary: hypoventilation pneumonia, chronic bronchitis, arrhythmias, myocardial emphysema, etc;
- extrapulmonary: heart failure, pulmonary heart, arrhythmia, myocardial dystrophy, complications associated with prolonged use of glucocorticoids.
Diagnosis of bronchial asthma includes:
- Physical examination. The severity of symptoms depends on the phase of the disease and the severity of the course. With an uncompensated course of the disease, rapid breathing and cardiac contractions are manifested, arterial pressure rises, a percussion sound is observed, participation in the breathing of the auxiliary muscles of the chest. Breathing hard, dry whistling wheezes are observed.
- Allergological examination
- Laboratory research. Mandatory: a general analysis of sputum, complete blood count, bacteriological examination of sputum.
- Additional: analysis of blood pH, arterial blood gas composition, determination of serum levels of IgA, IgM, IgG, protein fractions and other.
- Instrumental studies. Required: radiography of the chest, sinuses; study of respiratory function; electrocardiography. Additional: bronchomotor tests, diagnostic bronchoscopy.
Therapy of allergic conjunctivitis includes the following activities:
- Prevention. It consists of timely diagnosis and adequate treatment of bronchial asthma, concomitant somatic and allergic diseases, cessation of contact with the allergen and nonspecific environmental stimuli, refusal to take non-steroidal anti-inflammatory drugs and acetylsalicylic acid, adrenoblockers. Prevention of respiratory viral infectious diseases, premedication before invasive examination methods, exclusion of occupational hazards.
- Pharmacotherapy of bronchial asthma includes the relief of attacks and exacerbations of the disease, basic therapy. For the relief of seizures, inhaled short-acting β2-antagonists, local and systemic glucocorticoids, and short-acting methylxanthines are used.
- The relief of attacks is carried out with the use of inhaled drugs – inhalers, systemic drugs. To improve sputum discharge, respiratory motor stimulants and mucolytics are used.
- Allergen-specific immunotherapy (ASIT). It is performed in patients with accurate identification of causative allergens during periods of remission.
- Patient education (conversations about the nature of the disease, measures of prevention of exacerbations and methods of treatment).