Asthma in adults

Patients present with recurrent episodes of shortness of breath, chest tightness, wheezing, or coughing.

Examination typically demonstrates an expiratory wheeze; however, in severe asthma there is poor air entry and the chest is silent.

Treatment is stepwise, based on symptoms. Patients may need to monitor their peak expiratory flow daily and should be aware of the warning signs of a severe attack.

Some patients may develop progressive, irreversible obstructive lung disease.

Asthma is a chronic inflammatory airway disease characterized by intermittent airway obstruction and hyperreactivity. Many cellular components are involved in the asthmatic pathway, including mast cells, eosinophils, T lymphocytes, macrophages, neutrophils, and epithelial cells. On insult, in susceptible people, inflammation causes increased bronchial hyperresponsiveness and recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, which are usually associated with widespread but variable airway obstruction that is reversible either spontaneously or with treatment.[1]National Institutes of Health; National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert panel report 3: Guidelines for the diagnosis and management of asthma. August 2007. http://www.nhlbi.nih.gov/ (last accessed 11 October 2016). https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma