Asthma in Women, Asthma in Pregnancy (cont.)

Between 12 and 15 million people in the U.S. have asthma (7). One 1998 estimate from the Centers for Disease Control, was even higher at 17 million. In 1998, asthma cost the U.S. $11.3 billion (2).

Diagnosis (Symptoms): How Does a Woman Know She Has Asthma?

There are many hints that a woman has asthma, but she may not recognize it as asthma. Understanding the symptoms is easier after realizing what is actually happening during the attack.

A few major things happen during an asthma attack. First of all, the muscles lining the airways spasm, meaning tighten up, and this causes the tubes to become narrow. Secondly, to make matters worse, more mucus is produced than usual. The mucus can block the flow of air in the already narrow tubes. These changes are responsible for the symptoms of asthma, the hints that someone has asthma. The inflammation causes wheezing, breathlessness, chest tightness, and cough, which tend to be worse in the night and early morning. Asthmatics tend to be more sensitive to things that generally irritate the airways, like heavy scents and smoke. Sometimes people have disrupted sleep from asthma because they wake up with coughing or trouble breathing. Asthma can get better, stay the same, or get worse with time. It is pretty much impossible to predict what will happen years down the road in a given person.

Asthma attacks can be mild, moderate, or severe. Fortunately, they only rarely lead to death. Mild or moderate attacks may show up as coughing, chest tightness, or a wheezing (whistling type of noise) during breathing. Any one person can have any one or a combination of these symptoms.

Many people do not know that coughing by itself can be a symptom of asthma. In fact, asthma is one of the three top causes of chronic cough. Also, many people only experience symptoms of asthma with a viral respiratory infection, as during a bad cold. Alternatively, asthma may show up as a cough that occurs only during or after exercise.

In severe attacks, the woman feels short of breath, has trouble talking, and may notice retraction (sucking in) of the muscles surrounding the ribs. This is called intercostal retraction. Bluish nails or lips may signal lack of sufficient oxygen to the tissues due to severe asthma. The extreme respiratory difficulty can also cause the neck muscles to work harder. She may notice a very fast heartbeat.

The official diagnosis of asthma requires 3 things. First, episodes of symptoms suggesting blockage of air-flow (airflow obstruction) must be present. The obstruction must be at least partly reversible (it can respond to medication), and other explanations for the symptoms must be ruled out (2).

There is an asthma screening program occurring in convenient locations, such as malls and health fairs, that is carried out by the Nationwide Asthma Screening Program. More information on screening dates and locations is available (14).