A patient with symptoms of asthma usually gives a history of recurrent breathing problems (dyspnea) and shortness of breath, the dyspnea is usually worse at night and the patient may have to prop up in bed or sleep the remainder of the night in a sitting position.
The breathing problems may start along with a cold so that it seems that the patient simply did not recover from the cold. Along with the attack is a lot of coughing and this seems to be the only way to get a deeper breath of air. The way this can be explained is that due to the bronchoconstriction (=spasm of the air tubes) air gets trapped in the air sacs (called alveoli) and only coughing squeezes the air out to a certain extent.
The problem with asthma is that due to bronchiolitis the air gets trapped and proper oxygen/carbon dioxide exchange cannot occur. As explained above, the physician can readily hear this as wheezing with the help of the stethoscope. But with an asthma attack an observant person standing near-by can often hear the wheezing also as can the patient.
A chronic cough is another symptom that often occurs, made worse with exercise or brought on by cold air. Parents are not infrequently the ones who pick up on this with a child that might cough in the sleep, but may be relatively OK during the day. If the physician measures the PEF with a peak flow meter, this can show at this point in time very often that early mild intermittent asthma is present.
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