The symptoms and clinical features of bronchial asthma consist of a triad of dyspnea, cough and wheezing, the last often being regarded as the sine qua non. In its most typical form, asthma is an episodic disease, and all three symptoms coexist.
At the onset of an attack, patients experience a sense of constriction in the chest, often with a non-productive cough. Respiration becomes audibly harsh, and wheezing in both phases of respiration becomes prominent, expiration becomes prolonged, and patients frequently have tachypnea, tachycardia and mild systolic hypertension. Mr Lim physical examination revealed his HR to be 108bpm, BP140/86mmhg, RR 20/min.
The lungs rapidly become over inflated and the anteroposterior diameter of the thorax increases. If the attack is severe or prolonged, there may be a loss of adventitial breath sounds, and wheezing becomes very high pitched. Further, the accessory muscles become visibly active, and frequently, a paradoxical pulse will develop. These two signs have been found to be extremely valuable in indicating the severity of the obstruction. Mr lim had laboured breathing with accessory muscle of respiration used at work and flaring of ala naesi.His chest was slightly barrel shaped and hyper-resonant on percussion which coorelate with the explanation given above.( ©2005-2009 WebMD, LLC. )
In conclusion the attacks are characterised by shortness of breath, cough, wheeze,
hoarseness or inability to sleep through the night.
Death from asthma is still a very uncommon event. Five thousand people die each year from asthma. Each year, asthma is responsible for 1.5 million emergency department visits, 500,000 hospital admissions, and 100 million days of restricted activity. In lost work and productivity, asthma is responsible for approximately $13 billion each year. Asthma accounts for more school absences and more hospitalizations of children than any other chronic illness.
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