Asthma is a chronic inflammatory disorder of the airways, in which many cells and play a role. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night and in the early morning.
These episodes are usually associated with widespread but variable airflow obstruction within the lung that is often reversible .
Clinical features
Typical symptoms include recurrent episodes of wheezing, chest tightness, breathlessness and cough. Asthma is commonly mistaken for a cold or chest infection which is taking time to resolve . precipitants include exercise, particularly in cold weather, exposure to airborne allergens or pollutants, and viral upper respiratory tract infections. Wheeze apart, there is often very little to find on examination. An inspection for nasal polyps and eczema should be performed.
Patients with mild intermittent asthma are usually asymptomatic between exacerbations. Individuals with persistent asthma report ongoing breathlessness and wheeze, but these are variable, with symptoms fluctuating over the course of one day, or from day to day or
month to month.
Management Setting goals
Asthma is a chronic condition but may be controlled with appropriate treatment in the majority of patients. The goal of treatment should be to obtain and maintain complete control , but aims may be modified according to the circumstances and the patient. Unfortunately,
surveys consistently demonstrate that the majority of individuals with asthma report suboptimal control, perhaps reflecting the poor expectations of patients and their clinicians
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