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| via: indiachest.org |
Can be diagnosed by blood tests, sputum tests, X-ray ...
Definitive diagnosis: based on clinical and subclinical (mainly clinical).
Subclinical
- CBC: E increases above 10%. If multiple infections increased leukemia, N increases.
- X-ray: pulmonary stretch image (in asthma: brightening lung, intercostal expansion, dome diaphragm lowered and flattened, increased size about light after heart).
- Sputum test: E, bronchial cells, Charcot-Leyden crystals.
- Respiratory Function: obstructive ventilatory disorders or mixed disorder recovery.
If typical asthma, asthma diagnosis based on symptoms lamsang., But objective criteria for diagnosing asthma patients is airway obstruction or changes:
+ Test bronchial recovery: a simple way to confirm the diagnosis.
FEV1 measurements, then spray 2 puffs Salbbutamol dose of 200mg - 300mg. After 30 minutes, measure again. If FEV1 increase> 15% positive bronchial recovery tests.
+ Change the time of day: monitored by measuring the PEF.
PEF ≥ 20% change in the day (morning, evening) have diagnostic value of bronchial asthma.
+ Stress Test: when normal pulmonary function test the 6m (note no history of ischemic heart this test) found that 50% of patients with asthma PEF at least 15% after walking)
+ Test stimulus: inhaled histamine or Methacolin will cause an asthma attack at a concentration much lower than normal (100 mg compared with »10.000mg normal). This test is dangerous only in areas where experience and patients with asthma is unclear.
Note: some patients with asthma, but only the symptoms of cough, especially at night, if you suspect asthma can test the recovery and treatment trials.
- Test for the diagnosis of asthma allergens exogenous.
Be clinically
Asthmatic children: severe shortness of breath whistled common in children especially when respiratory virus infection, 1/3 of patients may have asthma but is usually diagnosed bronchitis spasms. Such diagnosis leading to inappropriate treatment (antibiotics + cough) patients easy can turn into severe asthma, teratogenic chest, lower body development.
There are two types of disks attached to wheezing in children:
+ Do not have the address allergic wheezing only when respiratory virus infection, while an older child, the child's airway development, then go away.
+ The local allergic reaction: shortness of breath worse respiratory virus infections, but will have asthma during the children (this group often accompanied by allergic conditions such as: eczema, allergic rhinitis, with food allergies or other signs of allergy). Both groups if aggressive treatment such as asthma have good results.
To asthma
Mechanisms like the patient breathing cold and dry air increases the osmotic pressure of the respiratory tract; cold, dry air stimulation causes constriction of the airways increases animation of elements N and histamine. Can prevent exercise induced asthma by breathing warm, moist air on exertion, or use drugs b2 before exertion.
Occupational asthma
Some cases of asthma when exposed to occupational dust pollution as: in rubber factory workers, exposed with Epoxy and workers in the wood shop, bread, produce a number of drugs and biological products, cotton, fabric, yarn ...
Diagnosis of occupational asthma as a human organ can Atopy never had asthma, very susceptible to occupational asthma, when working in a number of jobs as mentioned above, often an asthma attack at the end of the day or evening after work, help shortness of breath after the weekend.
Differential Diagnosis
Chronic obstructive pulmonary disease: late-onset (after 40 years), with a history of smoking for many years, or exposure to dust, smoke, do not have a family history of asthma, patients with no history of allergies. History of chronic coughing, shortness of breath on exertion sometimes have difficulty breathing attack. Respiratory function: obstructive ventilatory disorders or irreversible mixture. Test recovery bronchitis negative.
Cardiac asthma
In people with mitral valve stenosis, aortic openings, left heart failure. Night due to accumulation of blood in the lungs, congestion, edema, bronchial stimulation causes muscle spasms.
Symptoms: severe nocturnal dyspnea, lung hear snakes hissing, irritation, moisture Iran, pink foam sputum, X-ray lungs: lung images heart, diuretic therapy, anti-heart failure, shortness of breath support.
