What are the clinical manifestations of severe asthma

There are different levels of asthma, and for patients with severe asthma, the damage caused will be more serious. They often show symptoms of difficulty breathing, anxiety, tension, irritability and confusion, or may also cause lung signs.

1. Difficulty breathing

Severe wheezing, rapid breathing, labored exhalation, sitting breathing, the three-recess sign, and even paradoxical chest and abdominal movements.

2. Mental and Consciousness

Anxiety, fear, tension, irritability, and in severe cases, confusion.

3. Pulmonary signs of acute severe asthma

The chest is full and in an inspiratory state, the breathing amplitude decreases, and both lungs are filled with loud wheezing sounds. When there is an infection, wet hiccups may be heard. The wheezing sounds may also be significantly weakened or disappear due to physical exhaustion or extensive sputum plugging in the small airways, resulting in "silent lungs", indicating a serious condition.

4. Pulse

The pulse rate is often greater than 120 beats/min, with pulsus paradoxus. In critically ill patients, the pulse rate may become slower or irregular, and pulsus paradoxus may disappear.

5. Moist and sweaty skin

When dehydrated, skin elasticity decreases and critically ill patients may develop cyanosis.

6. Number of breaths: In severe asthma, a series of changes occur in respiratory dynamics. The expiratory flow rate is limited, and thus the tidal volume is reduced. To maintain adequate ventilation, the patient can only increase the respiratory rate, thus forming a shallow and rapid breathing pattern. A respiratory rate of >30 times/minute indicates a serious condition.

7. Participation of auxiliary respiratory muscles: Under normal circumstances, inhalation is active, while exhalation is passive. When asthma attacks severely, the expiratory flow rate is limited, exhalation becomes active, the activity of the auxiliary respiratory muscles is enhanced, and the sternocleidomastoid muscle contracts excessively.