By: Tia Leslie and Anna Cranmer

 Asthma is a chronic condition involving the respiratory system in which the airways occasionally constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers.  Asthma affects 5-7% of the population of North America and Europe, and usually goes undiagnosed.

 Asthma is caused by both environmental and genetic factors that researchers do not yet fully understand.  It could be triggered by allergens, tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, emotional stress, traffic pollution, or poor air quality. In children, the most common triggers are viral illnesses such as those that cause the common cold.  Research experts have also come up with such theories as the “pool chlorine hypothesis” which states, “long-term attendance at chlorinated swimming pools was found to correlate strongly with the probability of children having asthma” (wikipedia)

 The airway narrowing causes symptoms such as wheezing, shortness of breath (dyspnea), chest tightness, and coughing  A rapid heart rate (tachycardia), rhonchus lung sounds (audible through a stethoscope), the presence of a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest.  Refractory asthma can develop if milder asthma is undetected  During very severe attacks, an asthma sufferer can turn blue from lack of oxygen, and can experience chest pain or even loss of consciousness. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs, the palms may start to sweat, and the person's feet may become icy cold. Severe asthma attacks, which may not be responsive to standard treatments are life- threatening and may lead to respiratory arrest and death.

 Acute Bronchoconstriction Allergen-induced or cause by aspirin or NSAIDs, exercise, cold air, irritants or stress.  Airway Edema The airway becomes impenetrable because of a release of inflammatory mediators that cause increased thickening and swelling of the airway  Chronic Mucus Plug Formation In severe asthma, mucus secretion and the formation of thickened mucus plugs can cause persistent airflow limitation  In some individuals, asthma is characterized by chronic respiratory impairment.  In others it is an intermittent illness marked by episodic symptoms that may result from a number of triggering events, including upper respiratory infection, stress, airborne allergens, air pollutants (such as smoke or traffic fumes), or exercise.

 Allergies go hand in hand with asthma  Exercise Induced Asthma is triggered by physical exertion  Cough-Variant Asthma  Nocturnal Asthma

 The symptoms are much more prevalent during physical exertion  Occurs after several minutes of vigorous aerobic activity  Causes include allergens but this asthma occurs differently than other types.  Breathing through the mouth results in air that has not been warmed and humidified by the nose which seems to generate increased blood flow to the linings of the bronchi  Then constriction of these vessels follows without the inflammation

 The medications used to treat asthma are classified as either controller or rescue (reliever) medications.  The most effective treatment for asthma is identifying triggers, and limiting or eliminating exposure to them.  A nebulizer which provides a larger, continuous dose can also be used. Nebulizers work by vaporizing a dose of medication in a saline solution into a steady stream of foggy vapour, which the patient inhales continuously until the full dosage is administered.  Inhalers are short-acting, selective beta2- adrenoceptor agonists, or bronchodilators such as salbutamol (albuterol USAN), levalbuterol, terbutaline and bitolterol.  Bronchodilators expand the airway

 A basic Inhaler  A nebulizer

 A peak flow meter is an inexpensive, pocket-sized device that measures peak expiratory flow (PEF), or how fast a person can breathe out. To measure PEF, the person takes a deep breath and then blows into a tube on the peak flow meter as hard and as fast as possible.

 Tremors was a major side affect of these drugs has been reduced by inhaled medications.  There can be an elevated heart rate or blood pressure.  These medications should only be used when needed.  A tolerance can build up and efficiency can decline leading to refractory asthma and death.

 Chest tightness  Coughing  Prolonged shortness of breath  Wheezing after or during exercise  Inability to catch their breath  Physical activities affected by breathing difficulty  Use of accessory muscles to breathe  Breathing difficulty when exposed to certain allergens or irritants  An athlete who is well conditioned but does not seem to be able to perform at a level comparable with other athletes who do not have asthma  Family history of asthma  Personal history of atopy, including eczema or hay fever (allergic rhinitis)

 It is up to the athlete to bring medication if they know they have asthma.  An athletic trainer should have a PEF (peak expiratory flow meter) with them.  They should also have an inhaler with their supplies for precaution.

 It is easier to detect asthma in athletics because more of the symptoms come out during exercise.  There is a relatively high incidence of asthma in sports such as cycling, mountain biking, and long-distance running, and a relatively lower incidence in weightlifting and diving.  It is unclear how much of this statistic is from the effects of training in the sport, and from self-selection of sports that may appear to minimize the triggering of asthma

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