Presents as an acute or subacute episode of progressive worsening of symptoms, such as shortness of breath, wheezing, cough, and chest tightness.
Pulse rate, respiratory rate, subjective assessment of respiratory distress, accessory muscle use, and auscultation of the lung fields are key factors to assess during physical exam.
An increased airway obstruction that can be quantified objectively by peak flow measurement or FEV1 is typical in an acute exacerbation.
Early administration of bronchodilators and corticosteroids relieves airflow obstruction and helps to prevent future relapses. Severe exacerbations often require additional therapy including oxygen, magnesium, and, in some circumstances, mechanical ventilation.
Pneumonia, pneumothorax, pneumomediastinum, and respiratory failure are complications.
An asthma exacerbation is an acute or subacute episode of progressive worsening of symptoms of asthma, including shortness of breath, wheezing, cough, and chest tightness. Exacerbations are marked by decreases from baseline in objective measures of pulmonary function, such as peak expiratory flow rate and FEV1.
History and exam
- viral infection
- respiratory bacterial infection
- current smoker or exposure to secondhand cigarette smoke
- exposure to allergens (including history of seasonal allergic rhinitis)
- atopic eczema
- environmental irritants
- poor indoor air quality
- gastroesophageal reflux disease
- history of asthma
- history of hospitalization for asthma exacerbations
- use of oral corticosteroids
- noncompliance to asthma medication
Pulmonary, Critical Care and Sleep Medicine
VA Palo Alto Health Care System
SM declares that he has no competing interests.
Dr Sourav Majumdar would like to gratefully acknowledge Dr Ware Kuschner, Dr Michael Ezzie and Dr Jonathan P. Parsons, the previous contributors to this monograph.
Pulmonary and Critical Care Medicine
University of Vermont
AD declares that she has no competing interests.
Professor of Respiratory Medicine
Institute of Infection, Immunity & Inflammation
University of Glasgow
NCT declares that he has no competing interests.
Consultant Chest Physician
Chest Clinic C
Aberdeen Royal Infirmary
GPC declares that he has no competing interests.
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