Asthma Clinical Classification, Phases and Stages of Acute Asthma Attack

Asthma is a respiratory tract disorder causing difficulty in breathing.

Clinical Classification of Asthma:

Asthma is classified clinically on the basis of the Asthma attack of the patient.

1. Mild intermittent asthma: In this case, the patient is attacked by Asthma twice a week or less.
2. Mild persistent asthma: In this case, the attack occurs more than twice weekly.
3. Moderate persistent asthma: The attack occurs almost daily and is severe that it affects the activity of a person.
4. Severe persistent asthma: In this case, attacks are very frequent and persist for a long period of time; these attacks severely limit the activity of the patients.

Phases of Asthma:

Asthma is divided into two phases on the basis of the response of the patient to the triggers. The two phases are:

1. Early phase
2. Late phase

1. Early phase of Asthma:

The early stage of Asthma is characterized by the

• Marked constriction of the bronchial airways
• Bronchospasm
• Edema of the airways
• Excessive mucus production

The bronchospasm is due to the increased release of inflammatory mediators like histamine, prostaglandins, and bradykinins. In the early stages of the Asthmatic response, they promote bronchoconstriction rather than inflammation.

2. Late phase of Asthma:

The late phase of Asthma occurs several hours after the initial onset of the symptoms and manifests mainly as an inflammatory response. Eosinophils are the white blood cells, which are the primary mediators of inflammation during the Asthmatic response. Eosinophils stimulate the degranulation of the mast cells and release the substances that attract other white blood cells to that area. Subsequent infiltration of the airway tissues with white blood cells like lymphocytes and neutrophils contributes to the overall inflammatory response of the late phase of Asthma.

Stages of an Acute Asthma Attack:

There are four stages in the Asthma attack:

Stage I: It is a mild attack and the patient feels mild dyspnea, and diffuse wheezing and there will be adequate air exchange.

Stage II: It is a moderate stage and the symptoms will be respiratory distress while taking rest and marked wheezing.

Stage III: It is a severe stage and the patient suffers from marked respiratory distress and cyanosis. He experiences marked wheezing and absence of breath sounds.

Stage IV: It is the stage of respiratory failure. The patient suffers from severe respiratory distress, lethargy, confusion, and prominent pulsus paradoxus.