Pathophysiology Mechanisms of Chronic and Acute Asthma Exacerbation


Pathophysiology Mechanisms of Chronic and Acute Asthma Exacerbation

Chronic and Acute Asthma are inflammatory conditions that are very common in industrialized countries. As explained by Buhl & Farmer (2004), the issues that lead to these conditions lead to the airways of the patient to narrow causing wheezing. This situation needs to be controlled through medication and frequent treatment and medical checkups. The airways themselves may keep changing leading to different levels of asthma. Acute and chronic asthma can be reversed if the patient seeks medical attention as soon as possible. On the other hand, it gets worse if the condition is delayed. As noted by Yamada (2003), the changes in the airways of the patient include such complications as eosinophilis. Eosinophilis is a condition that affects the immune system that when affected, combats many parasites that affects the chest of the patient with time. These parasites also increase cases of allergy, eventually leading to asthma. They generate themselves in the bone marrow of the patients, making it difficult to treat. Without treatment, the parasites are likely to spread to the blood. Acute and chronic asthma are the main killer diseases for children with a high hospital admission rates. Another change in the airways include lamina reticularis thickening. In this case, the airways prolong increasing the number of mucous glands. Other cells are T-lymphocytes, macrophages, neutrophils, cytokines, chemokines, histamine, and leukotrienes. They are known to lead to the changes above named on the blood gas patterns during exacerbation. This is the case both for acute and chronic asthma.

Children compared to adults are at a greater risk of suffering from Chronic and Acute Asthma. This explains the reason why most patients of asthma are children. Chronic asthma kills more children that acute asthma. The main reason is the poor immunity that children have compared to adults. Exacerbation in acute asthma is referred to as asthma attack with patients showing different symptoms. This implies that children are more susceptible to acute and chronic asthma compared to adults. The cells of adults are stronger and more resistant compared to those of adults. In the same point of view, Pathophysiology of acute and chronic asthma is also different in children. In most cases, asthma can be stable in adults for some weeks, but for children, a day is enough for them to die. After both conditions, the result is acute and chronic asthma. Different people are affected in different ways all together. Several factors in the home affect the exacerbation of asthma in children most especially. These are dust, cat and dog fur, allergens and mold. Children will as well be affected by perfumes causing acute or chronic asthma. These factors affect the respiratory tract hence making the diseases worse. Children will therefore have a higher level of exacerbation in children than adults ( Knight-Madden, Forrester, Lewis & Greenough (2005).

Diagnosing asthma is not something new in the field of medicine. Managing these conditions however has been a challenge to most medical practitioners with more children and adult patients dying from it every other day. Asthma is generally an inflammatory condition that affects the airways, cells, and other elements that are easy to treat. This leads to wheezing, breathlessness, tight chest and regular coughing. Most patients experience a lot of coughing whenever it is cold, especially early in the morning and late in the evening. The diagnoses of these conditions are easier to come up with most especially if the patient’s family has some history of the disease. In this case, the patient is affected after much exercise, viral infections, air pollution and allergies. To confirm the diagnosis, a process called spirometry is conducted as explained by Zimmerman, Woodruff, Clark & Camargo (2000). The only difficult in this case of spirometry is when the patient is a child of less than six years.

As explained by Wang & Petsonk (2004), spirometry is one of the known successful steps towards diagnosing and managing acute and chronic asthma. It is the best and the only mode that guarantees success. In this case, spirometry measures the FEV1 and if it shows an improvement of twelve percent or more, medication and management starts right away. This follows the application and use of bronchodilator. One of the best known bronchodilator is salbutanol that doctors have used to support the diagnosis of these illnesses. People who face simple asthma attacks are also advised to go through this process. It reduces chances of the illness getting more serious. It is also an obvious way of reducing cases of deaths to a high percentage both in children and in adults. Since there can be different types of asthma depending on the degree of infection, single breath diffusing capacity goes a long way in helping diagnose asthma. The patients should have medical attention as well as try to maintain a two to three year intervals of checkups through Spirometry. It is worthy to mention that this process is performed to patients with both acute and chronic asthma conditions.


Mind map for Acute Asthma


Oxygen administration


Over seven million children diagnosed worldwide

Close to 34 million Americans affected

Blacks have higher mortality and morbidity than whites
1:2 female to male ratio at childhood
Acute Asthma




Hypoxemia & respiratory alkalosis
Dyspnea & chest tightness
Exposure to Allergen
Airway obstruction & increased mucous secretion
Atopy takes place
Cross-link with mast cells
Clinical presentation


Pulmonary function test
Pulse oximetry
Chest X-ray


Mind map for Chronic Asthma



Over 300 million people affected worldwide
Common in countries that are underdeveloped
Affects mostly the male
Anticholinergic medications
Mast cell stabilizers



Chronic Asthma



Shortness of breath
Chronic cough
chest tightness
Increased mucus
Swelling and inflammation
Muscle tightening
Clinical presentation


Spirometry to children above six years
Chest X-ray




Buhl, R., & Farmer, S. G. (2004). Current and future pharmacologic therapy of exacerbations in chronic obstructive pulmonary disease and asthma. Proceedings of the American Thoracic Society, 1(2), 136-142.

Knight-Madden, J. M., Forrester, T. S., Lewis, N. A., & Greenough, A. (2005). Asthma in children with sickle cell disease and its association with acute chest syndrome. Thorax, 60(3), 206-210.

Wang, M. L., & Petsonk, E. L. (2004). Repeated measures of FEV1 over six to twelve months: what change is abnormal?. Journal of occupational and environmental medicine, 46(6), 591-595.

Yamada, T. (2003). Significance of complications of allergic diseases in young patients with interstitial cystitis. International Journal of Urology, 10(s1), S56-S58.

Zimmerman, J. L., Woodruff, P. G., Clark, S., & Camargo Jr, C. A. (2000). Relation between phase of menstrual cycle and emergency department visits for acute asthma. American journal of respiratory and critical care medicine, 162(2), 512-515.



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