Bronchial asthma; Exercise-induced asthma

Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.

Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely restricted.

Symptoms include:

• Cough with or without sputum (phlegm) production
• Pulling in of the skin between the ribs when breathing (intercostal retractions)
• Shortness of breath that gets worse with exercise or activity
• Wheezing, which:
  • Comes in episodes with symptom-free periods in between
  • May be worse at night or in early morning
  • May go away on its own
  • Gets better when using drugs that open the airways (bronchodilators)
  • Gets worse when breathing in cold air
  • Gets worse with exercise
  • Gets worse with heartburn (reflux)
  • Usually begins suddenly

Emergency symptoms:

• Bluish color to the lips and face
• Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack
• Extreme difficulty breathing
• Rapid pulse
• Severe anxiety due to shortness of breath
• Sweating

Other symptoms that may occur with this disease:

• Abnormal breathing pattern --breathing out takes more than twice as long as breathing in
• Breathing temporarily stops
• Chest pain
• Tightness in the chest

Allergy testing may be helpful to identify allergens in people with persistent asthma. Common allergens include:

• Cockroach allergens
• Dust mites
• Molds
• Pet dander
• Pollens

Common respiratory irritants include:

• Fumes from burning wood or gas
• Pollution
• Tobacco smoke

The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard. However, lung sounds are usually normal between asthma episodes.

Tests may include:

• Arterial blood gas
• Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin)
• Chest x-ray
• Lung function tests
• Peak flow measurements

Images

Spirometry

Asthmatic bronchiole and normal bronchiole

Lungs

Peak flow meter

Asthma

Respiratory system

Normal versus asthmatic bronchiole

Exercise-induced asthma

Common asthma triggers

Review Date: 05/01/2011
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)