Bronchial Asthma (BA) is a common condition. The complications of BA can be severe, yet patients often overlook these complications.
During the winter and spring, cold weather creates favorable conditions for the complications of asthma to occur, so it is essential for everyone to be aware and take precautions.
 |
Images of normal bronchial lungs and images of bronchial lungs in patients with asthma. (Photo: Tuổi trẻ) |
According to the World Health Organization (WHO), asthma poses a significant threat to humanity and is one of the most common chronic diseases. Currently, there are approximately 300 million people with asthma worldwide, and this number is expected to rise to 400 million by 2025.
Southeast Asia is a region where asthma prevalence is rapidly increasing: Malaysia 9.7%, Philippines 11.8%, Thailand 9.2%, Singapore 14.3%, and Vietnam about 5%. Annually, asthma causes 200,000 deaths worldwide, with Vietnam accounting for 3,000 cases.
Asthma progresses in acute episodes, with each episode potentially worsening the condition and increasing danger, often leading to complications such as:
Pneumothorax: More than one-third of children hospitalized for asthma experience pneumothorax complications. Pneumothorax affecting one or multiple lobes occurs in about 10% of patients admitted to the hospital. When asthma is stabilized, the pneumothorax condition resolves.
Bronchial Infection: This is usually a complication in patients with chronic asthma. Seasonal changes, cold spells, sudden weather shifts during the day, and high humidity create favorable conditions for bacteria and viruses that cause infections in the ear, nose, throat, and lower respiratory tract, worsening asthma symptoms. Patients may experience fever, increased shortness of breath, and a productive cough. Blood tests typically show elevated neutrophil counts. Sputum tests may reveal degenerative white blood cells and mixed bacteria, and sometimes tuberculosis bacteria.
Multilobular Emphysema: The elasticity of the alveoli in asthma patients gradually decreases over time, resulting in reduced exhalation and increased residual volume. This condition is also known as emphysema. Patients may experience shortness of breath with exertion, and they might struggle to extinguish a match held at a distance. Symptoms include a productive cough, cyanosis of the lips and extremities, hyper-resonance upon percussion, decreased or absent breath sounds, and distant heart sounds. X-rays may show hyperlucent lungs, lowered diaphragm, heart shaped like a water droplet, blunted costophrenic angles, and horizontally oriented, widened ribs.
Pneumothorax and Mediastinal Emphysema: These conditions occur in about 5% of patients with chronic asthma. Due to the dilation of alveoli, blood vessels in the dilated areas become sparse and poorly nourished, increasing pressure within the alveoli. Strenuous activities or severe coughing can lead to alveolar rupture. Clinical signs are often subtle, necessitating chest X-rays for detection. Timely emergency treatment is crucial in the event of pneumothorax, as bilateral pneumothorax can lead to sudden death in asthma patients.
Chronic Cor Pulmonale: This occurs in 5% of patients with severe chronic asthma. Symptoms include exertional dyspnea, persistent cyanosis, pain in the right upper quadrant, and possibly hepatomegaly. Electrocardiograms may show tachycardia and peaked P waves. S waves may dominate in precordial leads. Asthma can have reversible respiratory function, so the time it takes for each patient to progress to chronic cor pulmonale can vary, potentially taking 5 years, 10 years, or even longer.
Respiratory Arrest with Cerebral Damage: This can occur due to prolonged respiratory failure, leading to cerebral hypoxia. Cardiac arrest and respiratory failure may happen in severe asthma cases. These situations often involve sudden choking episodes, resulting in increased CO2 levels in the blood, leading to mixed acidosis, ultimately causing coma and death.
Respiratory Failure: This condition is typically seen in hospitalized patients with severe acute asthma or malignant asthma. Patients may experience continuous cyanosis, difficulty breathing, and may require mechanical ventilation. This is also one of the causes of asthma-related mortality.
Asthma poses a significant burden on society; according to the WHO, the costs associated with asthma are greater than the combined costs of the two deadly diseases of the century: tuberculosis and HIV/AIDS.
The complications of bronchial asthma can be even more severe. Therefore, individuals with asthma and the wider community need to be informed to be proactive in treating asthma from its early stages according to medical advice, aiming to control asthma attacks and reduce episodes of shortness of breath throughout the week and day, which contributes effectively to managing asthma complications.
In the event of a severe asthma attack or suspected complications, patients must be urgently taken to emergency facilities in hospitals for timely examination and treatment.
