Diagnosis of bronchial asthma: basic methods

Diagnostics of bronchial asthma is carried out, focusing on a complete comprehensive examination of the patient's body. The receipt of positive treatment results depends on the correct diagnosis.

Protocols (standards) for determining the incidence, as well as further treatment of the adult population and children take into account various methods: clinical examination, collection of anamnesis, identification of symptoms, laboratory diagnostics.

After taking the necessary measures for each patient, an individual treatment regimen is selected, which helps to reduce the incidence and alleviate the patient's condition. Differential diagnosis of bronchial asthma takes into account all aspects (analyzes, symptoms, anamnesis, allergological examination and respiratory functionality.).

Diagnostic examination methods

Modern diagnostics in the development of bronchial asthma is an important task for a doctor, since adequate treatment is able to provide complete control over the disease with complete neutralization of symptoms in children and adults. For this, all criteria for asthma are assessed with the exclusion of COPD and a preliminary diagnosis.

Diagnostic protocols are carried out in several stages:

Finding out the anamnesis

Bronchial asthma, depending on the degree of morbidity, is determined most often in childhood and adolescence. As a rule, there is a genetic predisposition to the development of asthmatic diseases. In addition, its development is possible against the background of COPD.

A bronchial attack is often associated with the influence of certain factors, provoking characteristic symptoms (shortness of breath, cough, wheezing, weakness, etc.). An attack can appear suddenly. It can be stopped with inhaled bronchodilators. If the seizure persists after using the inhaler, further diagnostic protocols are needed, as well as the exclusion of COPD.

Visual inspection

At the initial stage of the disease, professional diagnostics is not able to determine any specific protocols in determining bronchial asthma, except for the exclusion of COPD. During a prolonged attack, a "barrel chest" symptom may occur, which is associated with difficulty exhaling. As a result, a gradual development of emphysema is possible, the criteria and protocols of which depend on the severity of symptoms and the stage of morbidity. Further treatment may depend on the results of the visual examination.

Auscultation and percussion

An important way of professional diagnosis is percussion (percussion) and auscultation (listening) of the lungs. As the attack progresses, wheezing and wheezing may be heard in the lungs. Percussion is effective for long-term disease and emphysema.

Laboratory diagnostic methods

Laboratory diagnostics involves the appointment of various types of analyzes, including:

• biochemical blood test - determines the number of eosinophils, which are markers of the allergic process. In addition, this analysis, in conjunction with an allergic test, allows you to identify a specific allergen to which the body reacts most sharply;
• general blood test - allows you to identify inflammatory processes, COPD and intoxication in the patient's body. Blood sampling is performed on an empty stomach;
• general sputum analysis - identifies characteristic asthmatic markers with characteristic Kurshman spirals and Charcot-Leiden crystals. In this case, viscous and thick sputum is determined, which can exfoliate in two layers. Microscopic examination determines eosinophils;
• feces analysis - helps to identify parasitic invasions, which often provoke the development of bronchial asthma. For example, roundworms, with their cyclical development, are able to penetrate the pulmonary system, causing general intoxication of the body, weakening of the immune system, and increased allergization of the patient;
• allergy test (including scarification) - the criteria for an allergy test make it possible to clarify the presence of a trigger in the blood, which causes a response chain of reactions in the blood, leading to bronchospasm. If the answer is positive, local signs of inflammation (itching, hyperemia, edema, etc.) may be observed.

Asthma is most difficult to diagnose when you have obstructive bronchitis (COB). This process manifests itself as chronic obstructive pulmonary disease (COPD).

Carrying out instrumental diagnostics

The protocols for performing this type of diagnosis serve as indicators for the final diagnosis.

X-ray

Professional X-ray is able to reveal increased airiness of the lung tissue (emphysema) and increased pulmonary pattern due to active blood flow to the lung tissue. However, it should be borne in mind that sometimes even an X-ray cannot reveal changes. Therefore, it is generally accepted that X-ray methods are deeply nonspecific.

Spirometry

This method is used to determine the FVD (functions of external respiratory activity) and is quite effective. Professional spirometry is able to determine a number of major indicators of respiratory activity.

The diagnosis of spirometry is as follows:

• the patient is invited to breathe through a special device (spirometer), which is sensitive and records all changes in breathing;

• the analysis of the examination is compared (by the doctor or the patient) with the recommended parameters of the FVD;
• based on the professional comparative characteristics of external respiration, the doctor establishes a preliminary diagnosis (for 100% confidence in the diagnosis, spirometry alone is not enough);
• if the patient has broncho-obstructive disorders (excluding COPD), this may indicate the manifestation of bronchial asthma.

In addition, spirometry data can determine the severity of an asthmatic attack and the effectiveness of the treatment in the case when it was used.

Peak flowmetry

This diagnostic method refers to innovations for monitoring and determining the development of bronchial asthma in an adult patient. The monitoring protocol with the participation of a peak flow meter has the following advantages:

• allows you to determine the reversibility of bronchial obstruction;
• the ability to assess the severity of the course of the disease;
• peak flowmetry protocols allow predicting the period when an asthmatic attack occurs, depending on the degree of morbidity;
• the ability to identify occupational asthma;
• monitoring the effectiveness of the treatment.

Peak flowmetry should be performed daily. This allows for more accurate diagnostic results.

Pneumotachography

Using this method of professional diagnostics, the peak volume and maximum space velocity at different levels, taking into account the percentage of FVC (forced vital capacity lungs). The maximum speed is measured at 75%, 50% and 25%.

Protocols for determining occupational asthma are the most difficult because certain chemicals in the air can trigger an attack. To confirm occupational asthma, it is necessary to clarify the anamnesis of an adult patient, as well as an analysis of indicators of external respiratory activity. In addition, it is imperative to pass tests in a timely manner (sputum, urine, blood, etc.) and carry out the necessary treatment.

Determination of allergic status

Simultaneously with the indicators of external respiration and depending on the severity of symptoms, prick tests (injection) and a scarification test are carried out to identify an allergic etiology. However, it should be borne in mind that the clinical picture of such examinations in some cases can give a false-positive or false-negative response. That is why it is recommended to conduct a blood test for the presence of specific antibodies in the serum. In professional diagnostics, it is especially important to clarify the allergic status in children.

Diagnosis of the disease in childhood

Diagnosis of bronchial asthma in children is often accompanied by great difficulties. This is primarily due to the symptomatology of the disease in children, which is similar to many other childhood diseases. Therefore, much depends on finding out the history with a tendency to allergic diseases. First of all, it is necessary to rely on the repetition of a nocturnal attack of bronchial asthma, which confirms the development of the disease.

In addition, diagnostic protocols provide for FVD (functional study of external respiration) with bronchodilators to prescribe adequate treatment tactics. It is quite natural that it is necessary to pass tests of sputum, blood and feces, as well as conduct spirometry testing and allergy examination.

Diagnosis of the disease in old age

It should be noted that it is difficult to diagnose an asthmatic attack in the elderly. This is primarily due to the abundance of chronic diseases that accompany bronchial asthma, "erasing" its picture. In this case, a thorough history taking, sputum and blood examination, and specific tests aimed at excluding secondary diseases are required. First of all, the diagnosis of cardiac asthma is carried out, the identification of coronary artery disease, accompanied by symptoms of left ventricular failure.

In addition, it is recommended to carry out functional methods for detecting bronchial asthma, including ECG, radiography, peak flowmetry (within 2 weeks). Only after all diagnostic measures have been completed, symptomatic treatment of bronchial asthma is prescribed.