Exercise-induced Asthma Symptoms, Diagnosis, Treatment, Causes: Exercise-induced asthma (EIA) refers to acute airway stenosis and increased airway resistance after intense exercise in patients with increased airway responsiveness. Sports asthma is not uncommon in the clinic. Exercise-induced Asthma Symptoms, Diagnosis, Treatment, Causes. According to statistics, 50% to 90% of confirmed asthma patients may have exercise-induced asthma; 40% of patients with undiagnosed allergic rhinitis may have exercise-induced asthma. Exercise-induced Asthma Symptoms, Diagnosis, Treatment, Causes.
Table of Content:
1: Exercise-induced Asthma symptoms
2: Treatment Exercise-induced Asthma
3: Exercise-induced Asthma Diet
4: Exercise-induced Asthma Preventive Care
5: Pathological Causes of Exercise Asthma
6: Exercise-induced Asthma Diagnosis
7: Exercise Asthma inspection
8: Exercise-induced Asthma Test
9: Prognosis Exercise-induced Asthma
10: Pathogenesis of Exercise-induced Asthma
1: Exercise-induced Asthma symptoms:
EIA (Exercise-induced Asthma) can occur in any age group, especially in adolescents. Patients usually develop chest tightness, wheezing, coughing, and difficulty breathing after a few minutes of strenuous exercise. The symptoms reach a peak 5 to 10 minutes after the exercise stops, and relieve themselves within 30 to 60 minutes. Only a few cases may last longer and require medication.
The appearance of EIA symptoms has a certain relationship with the type of exercise. The most common types of EIA sports are cycling, running, and figure skating. EIA is less likely to occur in warm, humid environments such as swimming, badminton, and tennis.
EIA can occur in any climatic conditions, but the chances of seizures increase when breathing dry and cold air, but not in warm, humid climates.
2: Treatment Exercise-induced Asthma:
1: Let the patient move in a warm, humid environment while avoiding the cold, dry environment.
2: It is recommended that the patient breathes with the nose without breathing during the exercise, but in practice, this measure is more difficult to complete, at this time the patient can wear a mask to warm and moisturize.
3: Warm-up exercise before strenuous exercise, because the study found that warm-up exercise can cause the patient to have an exercise refractory state, that is, the EIA patient reduces the degree of bronchospasm when performing the same exercise within 40 minutes after exercise, even Nothing happens.
2. Drug treatment:
1: β2 receptor agonist: It is the most effective drug for the treatment of exercise-induced asthma. About 90% of patients use β2 receptor agonist before exercise to prevent asthma attacks. Inhalants such as salbutamol (whaling aerosol) or terbutaline aerosol are recommended. Apply 10 to 20 minutes before exercise. If the exercise lasts for more than 2 hours, the symptoms of asthma and chest tightness may be repeated once. Long-acting β2 receptor agonists such as salmeterol can be used for up to 10 hours, which is suitable for long-term exercise or inconvenient application of drugs before exercise.
2: cromolyn: a mast cell membrane stabilizer, also the drug of choice for the treatment of EIA. The indication is that the application of the β2 receptor agonist alone cannot effectively control the seizure and the side effects of the β2 receptor agonist before exercise. The combination of cromolyn and a β2 receptor agonist can increase the efficacy. Chromic acid has two advantages: First, it does not increase heart rate, so it is suitable for elderly patients and patients with heart damage; second, it can prevent exercise-induced delayed phase bronchoconstriction.
3: Theophylline: It is not recommended as a first-line drug for preventing EIA because its diastolic bronchial smooth muscle function is relatively weak, side effects are large, and the onset time is slow. Oral quick-acting theophylline 100 ~ 200mg 2 h before exercise has a preventive effect.
4: anticholinergic drugs: can prevent some EIA attacks, but less effective than β2 receptor agonists and cromolyn. Asthmatic patients who are sensitive to cold air and polluted air are more effective with anticholinergic drugs. The slow onset feature limits its use in EIA.
5: Glucocorticoid: For patients with normal lung function at rest, prophylactic administration of β2 receptor agonist and/or cromolyn before exercise can effectively control seizures. For asthma patients with abnormal lung function at rest, it is necessary to control asthma and improve lung function in the treatment of EIA in order to make the above-mentioned pre-exercise treatment work. Long-term regular use of glucocorticoids can inhibit airway inflammation and reduce airway responsiveness. Once the patient’s resting lung function is normal, the above drugs can be used before exercise to prevent EIA attacks, just like patients with normal lung function. The immediate prevention of glucocorticoids is poor.
3: Exercise-induced Asthma Diet:
- The root of the red heart radish cruciferous herb Laiwu.
- Sea otter Piedmont, also known as jellyfish, white skin, is like a parachute, also like a white mushroom.
- Coffee powder Coffee beans are baked and baked in a variety of ways. They are baked and ground into powder, which can be directly brewed or boiled.
4: Exercise-induced Asthma Preventive Care:
Leukotriene receptor antagonists such as Angela and Shun Ning, antihistamine H1 receptor antagonists, and calcium channel blockers have certain preventive effects on EIA.
5: Pathological Causes of Exercise Asthma:
Exercise is the only motivating factor, and allergic rhinitis can also induce exercise-induced asthma. ‘ Exercise-induced Asthma Symptoms, Diagnosis, Treatment, Causes’.
6: Exercise-induced Asthma Diagnosis:
Through exercise tests and lung function tests, patients can get an accurate diagnosis. However, clinical diagnosis is often based on symptoms, medical history, and physical examination. EIA needs to be identified with the following diseases.
7: Exercise Asthma inspection:
Some experiments have found that the degranulation of eosinophils and mast cells in BALF is mildly increased after 3 hours of exercise, but other studies have not found EIA local airway tissue inflammatory cells and inflammatory mediators such as histamine, tryptase, and leukotriene C4. The content has changed.
Other auxiliary inspections:
Exercise test The standard exercise excitation test is the exercise plate test. Subjects continued to exercise for 6-8 hours while achieving maximum heart rate [(220-age) x 80%] (sub-maximal heart rate). The FEV1 or PEF was measured once every 5 minutes before and after the exercise and continued until 15 to 30 minutes after the exercise was stopped. If FEV1 or PEF falls more than 15% before exercise after exercise, it is positive for exercise stimulation test, which can diagnose exercise-induced asthma.
8: Exercise-induced Asthma Test:
See variability in asthma for complications.
9: Prognosis Exercise-induced Asthma:
The subjective factors affecting the prognosis of asthma and the age of the patients are very important indicators. Usually, the prognosis of children with asthma and adolescent asthma is better, while the prognosis of senile asthma is poor.
10: pathogenesis of Exercise-induced Asthma:
The pathogenesis of exercise-induced asthma has not yet been fully elucidated. At present, the following three factors are considered to be involved in the pathogenesis:
1: Heat loss and water loss During vigorous exercise, a large amount of air passes through the airway in a relatively short period of time; at the same time, the mouth breathing causes the inhaled air to enter the lower respiratory tract without being moistened and warmed by the nasal cavity, thereby causing the bronchial mucosal temperature to decrease. A large loss of airway moisture causes an increase in the osmotic pressure of the fluid on the surface of the respiratory epithelium. Physical stimulation such as increased osmotic pressure and decreased airway temperature can induce bronchial smooth muscle spasm.
2: Inflammatory response and inflammatory mediators Since the nature of asthma is chronic inflammation of the airways, it is considered that exercise-induced asthma is no exception. However, the results of the study are not exactly the same as expected. Although some experiments have found that the eosinophils and mast cells in the BALF have a slight increase in degranulation after 3 hours of exercise, other studies have not found EIA local airway tissue inflammatory cells and histamine, tryptase, leukotriene C4 and other inflammation. The content of the medium has changed. In recent years, the role of LTD4 in the pathogenesis of EIA has gradually been recognized. The concentration of LTD4 in BALF was significantly increased in patients with EIA. The administration of LTD4 receptor antagonist 20 min before exercise significantly reduced the extent of bronchospasm and shortened the recovery time.
3: Neural mechanism Studies have found that EIA patients have a lower sympathetic response than normal people during exercise; norepinephrine prevention before exercise can significantly reduce the degree of bronchospasm. ” Exercise-induced Asthma Symptoms, Diagnosis, Treatment, Causes” In addition, the vagus nerve is also involved in the pathogenesis of EIA.