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Asthma in Children and Adolescents

Description

An in-depth report on how asthma is diagnosed, treated, and managed in children.

Symptoms

In children with asthmatic symptoms, it is particularly important to first consider as a possible cause inhaled foreign objects such as peanuts, viral infections such as croup, and bacterial infections, which may be accompanied by high fever and progress rapidly. Any child who has frequent coughing or respiratory infections should be checked for asthma.

Typical Asthma Symptoms

The classic symptoms of an asthma attack are the following:

  • Wheezing when breathing out is nearly always present during an attack. Usually the attack begins with wheezing and rapid breathing, and, as it becomes more severe, all breathing muscles become visibly active.
  • Shortness of breath (dyspnea). Shortness of breath is a major source of distress in asthma patients, although severe dyspnea does not always reflect a serious attack or reduced lung function. In fact, some patients, particularly elderly patients, may not experience significant dyspnea but still have very poor lung function.
  • Coughing. In some people the first symptom of asthma is a nonproductive cough. In fact, in a 2001 survey, 12% of asthma patients reported coughing as a significant problem. Patients surveyed tended to feel that daytime cough was even more distressing than wheezing or sleep disturbances.
  • Chest tightness or pain. Initial chest tightness without any other symptoms may be an early indicator of a serious attack.
  • The neck muscles may tighten, and talking may become difficult or impossible.
  • Rapid heart rate.
  • Sweating.
  • Chest pain occurs in about three-quarters of patients. It can be very severe, although its intensity is not necessarily related to the severity of the asthma attack itself.
The end of an attack is often marked by a cough that produces a thick, stringy mucus. After an initial acute attack, inflammation persists for days to weeks, often without symptoms. (The inflammation itself must still be treated, however, because it usually causes relapse.)
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