In children with asthmatic symptoms, it is 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.
The classic symptoms of an asthma attack include:
Any of these symptoms may worsen with exercise, viral infections, exposure to irritants, stress, or changes in weather.
The end of an attack is often marked by a cough that produces 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.)
The following signs and symptoms may indicate a life-threatening situation:
Asthma often progresses very slowly to a serious condition, but at times a fatal or near-fatal attack may develop within a few minutes. It is very difficult to predict when an attack will become very serious.
Exercise-induced asthma (EIA) is a limited form of asthma in which exercise triggers coughing, wheezing, or shortness of breath. This condition generally occurs in children and young adults, most often during intense exercise in cold dry air. Symptoms are generally most intense about 10 minutes after exercising, then gradually resolve.
EIA is triggered only by exercise and is distinct from ordinary allergic asthma in that it does not produce a long duration of airway activity, as allergic asthma does. (However, some people have both forms of asthma.) People who have only EIA do not appear to need long-term maintenance therapy.
Asthma occurs primarily at night (nocturnal asthma) in as many as 75% of patients with asthma. Attacks often occur between 2 and 4 a.m. Some doctors believe that nocturnal asthma may actually be a unique form, with its own specific biologic mechanisms occurring only at night.
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