Asthma and the Elderly

Diagnosis and Relief for the Elderly Asthma Sufferer

Asthma is the inflammation of the bronchial tree causing increased mucus production, swelling (edema) of the tissue lining the airways, and spasms of the small muscles surrounding the airways, causing constriction of the airways. These symptoms manifest themselves as coughing, wheezing, chest tightness, and difficulty breathing, otherwise called an asthma attack.

Cardiac Asthma

Asthma is a hereditary disease and presents its strength at various times and in various stages of one’s life. For the elderly, however, asthma is more critical and less likely to be controlled. Some of the symptoms may be similar to that of childhood or adult asthma, such as wheezing and coughing, but the diagnosis may turn out to be very different. Cardiac asthma is the term used to describe asthma-like symptoms due to heart failure. Often elderly patients with no history of asthma are completely surprised to hear they have any form of asthma at all, not to mention one that affects their heart. Patients with cardiac asthma exhibit wheezing as a first indication that something is wrong with their heart due to asthma. Wheezing occurs as a result of a build-up in the lungs due to the failure of the heart to pump blood effectively.

In addition to a chest examination, there are many ways doctors check for heart failure. Evidence that the heart and liver are enlarged is a strong indication of danger. In some patients, heart failure is diagnosed when a chest x-ray reveals that the heart is enlarged and there is fluid in the lungs. Other key indicators are the widening of the veins of the neck, and swollen ankles. Ironically, patients are lucky to exhibit such symptoms because for many patients who do not have these characteristics, diagnosis is much more difficult to detect, leaving the disease untreated.

Treatment

The correct diagnosis is important because the therapeutic approach for cardiac asthma differs from routine asthma treatment in any other age group. The most common form of treatment for cardiac asthma patients is the use of diuretics, often used to reduce fluid build-up in the lungs. If successful, this form of treatment eliminates wheezing.

Emphysema

Emphysema may also be the cause of symptoms that are suggestive of asthma. Smoking cigarettes and cigars cause emphysema, and its effects can be deadly. Emphysema is a non-reversible obstruction of the airways, and the damage done to the air sacs by emphysema is unreversible and fatal. The walls between the air sacs are permanently broken down in emphysema and as a result, there is less surface for the exchange of oxygen and carbon dioxide to occur. Less oxygen passes into the circulation, causing a build-up in the bloodstream of the body’s waste product, carbon dioxide. Patients with emphysema are often short of breath and unable to exert themselves.

Diagnosing Emphysema

Emphysema brings with it a long line of symptoms that your doctor should looks for:

• Routine shortness of breath with slight to moderate physical exertion, such as walking briskly or climbing stairs
• Breathing faintly that can be detected through a stethoscope
• A long history of cigarette smoking
• X-rays to determine the amount of oxygen in the arterial blood artery
• Breathing tests
• The diffusion capacity of the lung to study your carbon monoxide

If diagnosed with emphysema, special care between you and your doctor is required to establish and follow a management plan. If the diagnosis of cardiac asthma is ruled out and you are diagnosed with asthma, then treatment is the same as any other asthma management plan.