What is an asthma attack?
A severe form of asthma can lead to a so-called acute asthma attack. This is an acute worsening of the symptoms. The most present symptom is the increasing shortness of breath, it becomes increasingly difficult to breathe and one begins to wheeze.
This in turn causes the body to panic, which further aggravates the shortness of breath. Often the affected persons use their entire respiratory muscles by supporting their hands and standing in the so-called goalkeeper position, for example. In addition, tachycardia, i.e.
a heart beating much faster, anxiety, confusion and cyanosis, i.e. a reduced supply of oxygen to the body, can also occur as a result of the breathing problems. It is therefore very important to calm the affected person. Breathing exercises, such as lip-braking, the administration of oxygen and fast-acting medications, such as inhaled beta-sympathomimetics or intravenous cortisone preparations, such as prednisolone, are quickly effective.
In some cases, the acute asthma attack cannot be sufficiently reduced despite proper therapy and can lead to the so-called status asthmaticus, which can sometimes have life-threatening consequences. This is an absolute emergency that must be treated immediately in hospital, as the shortage of breath can cause a pronounced oxygen deficiency in the body. You can find more information about this under: Asthma attack
How asthma is diagnosed
Depending on the development of asthma, various diagnostic tools can be used. The medical history, i.e. the doctor-patient consultation, and the physical examination always play a central role in the initial assessment. In addition, blood tests can provide more information about the type and severity of the inflammation.
The extent of the disease can be better assessed in chest x-rays and there are numerous functional tests of the lungs to determine the remaining breathing capacity. In everyday life, the tests used to examine the lungs in asthma are mainly the lung function test (also known as “Lufu”) and the methacholine provocation test. In the lung function test, different volumes are measured using a special mouthpiece, whereby the patient is asked to breathe in and out as deeply as possible. The methacholine provocation test uses the administration of methacholine (which causes the airways to contract) to test how strongly the lungs are irritated by this substance.
Consequences of asthma
If the disease is not treated properly or does not respond to treatment, there is a risk of worsening asthma attacks, some of which can be life-threatening and require immediate medical treatment (status asthmaticus). On the other hand, long-term damage to the lungs and the cardiovascular system can occur. The basic problem of an asthma attack is that the air can no longer leave the lungs, i.e. fresh air is no longer available, even if it appears during an attack that the person affected is “struggling for air”.
In the long run, several asthma attacks can put such a strain on the lungs that insufficient exhalation causes the lungs to over-inflate. This is called emphysema. This leads to severe, irreversible restrictions in lung function, which manifest themselves in a drop in performance and reduced resilience for the patient.
Another consequence of pulmonary hyperinflation can be a weakness of the right heart – called cor pulmonale. The reason for this is the constantly increased pressure in the lungs caused by the over-inflation, which puts excessive strain on the right heart. All these consequences can be avoided with the right treatment. This makes it all the more important to start treatment as early and consistently as possible.