What happens in the respiratory tract
The wall of the bronchus contains circular smooth muscles. When the receptors are irritated or under the influence of inflammatory substances, they contract, and the lumen of the bronchial tube narrows. At the same time, the mucous membrane swells and the production of thick mucus increases. Inhalation is easier than exhalation: when exhaling, the chest compresses the narrowed bronchi even more strongly. Air is retained in the lungs, they swell, the respiratory muscles work overload, and the person feels short of air and heaviness in the chest.
- Spasm of bronchial smooth muscles
- Swelling of the mucous membrane
- Accumulation of viscous sputum
- Difficulty in exhaling
- Overinflation of the lungs and fatigue of the respiratory muscles
Causes of bronchospasm
The most common cause in children and young adults is bronchial asthma, and in older smokers it is chronic obstructive pulmonary disease. Spasm can occur during acute viral infections, especially in young children, upon contact with an allergen, inhalation of smoke, chlorine, paints and dust. Certain medications can trigger an attack in sensitive people, so it is important to report any episodes to your doctor. Severe bronchospasm is part of an anaphylactic reaction.
- Bronchial asthma
- Chronic obstructive pulmonary disease
- Acute respiratory infections and obstructive bronchitis
- Allergic reaction and anaphylaxis
- Inhalation of smoke, vapors, dust, cold air
- Reactions to certain medications
- Physical activity in people with bronchial hyperreactivity
Symptoms and severity rating
The attack begins with a feeling of tightness in the chest and a dry cough, then wheezing appears, sometimes heard at a distance. The person takes a sitting position, leaning on his hands to connect the auxiliary muscles. The severity is assessed by simple signs: whether a person can speak in whole sentences, whether there are retractions of the compliant areas of the chest, what color of the skin and how often he breathes. A dangerous sign is the disappearance of whistling sounds with increasing shortness of breath: this means that almost no air is passing through.
- Feeling of tightness and heaviness in the chest
- Whistling noisy breathing, prolonged exhalation
- Dry paroxysmal cough
- Forced pose with support on hands
- Rapid breathing and heart rate
- Anxiety and feeling of shortness of breath
First aid and what not to do
Help the person sit up straight and lean forward slightly, unfasten tight clothing, open the window. If he has a prescribed emergency inhaler, help him use it, preferably through a spacer. You need to breathe calmly and slowly, without trying to force your exhalation. Remove the obvious irritant: smoke, strong smell, animal. You cannot put a person on his back, give him hot water, rub his chest with ointments with a strong odor, or give him sedatives. If after 10–15 minutes it does not get better or the condition worsens, call 103.
- Sit down, tilt the body forward, provide air
- Emergency inhaler through a spacer according to the prescribed scheme
- Calm slow breathing
- Remove smoke, odors, allergens
- Do not lay on your back, do not rub with harsh ointments
- If there is no effect - call 103
Examination and prevention
After the episode, it is important to find out the cause. The main method is spirometry with a reversibility test: it shows how narrowed the bronchi are and how they respond to a bronchodilator drug. A chest x-ray excludes pneumonia, foreign body and other lung diseases. If an allergy is suspected, total IgE and allergen panels are checked. Further treatment is directed to the underlying disease: for asthma, basic inhaled drugs are prescribed, for COPD - long-acting bronchodilators, and smoking cessation is recommended. The doctor selects the treatment.
- Spirometry with bronchodilation test
- Pulse oximetry during an attack
- Chest X-ray
- Total IgE and allergy panels
- Complete cessation of smoking, including passive smoking
- Vaccination against influenza and pneumococcus as recommended by a doctor