Asthma is classified as a chronic reactive airway disease which is characterized by episodes of reversible obstruction of the airway related to increased sensitivity of the tracheobronchial tree to a variety of stimuli. The sensitivity results in flare-ups of constriction of the bronchial airways.

An allergic component is involved in this condition which may be related to external or internal factors. External factors include allergens inhaled from pollen, mold, spores, dander from animals, or dust. Internal factors include some foods, such as shellfish, eggs, chocolate or drugs. In addition, an upper respiratory infection, exercise or occupational exposure may bring on an allergic response.

The occurrence and severity of symptoms vary from patient to patient, and from incident to incident. Some patients may have episodes that are mild and brief, while others have episodes of coughing and wheezing much of the time. Generally, characteristics of an attack include: acute episodes of wheezing, coughing, and shortness of breath; rapid pulse; and a feeling of tightness in the chest which may increase to respiratory distress. Severe episodes may result in cyanosis and progressive respiratory failure.

Tests will usually include a physical examination and lung auscultation which may show wheezing, rhonchi, and diminished breath sounds. Laboratory tests including an eosinophil count and sputum examination may be performed. Additional tests utilized include: pulmonary function tests; chest x-ray; a complete blood count (CBC); electrocardiogram (EKG); arterial blood gases (ABG); and allergen skin testing.

Treatment is designed to prevent the development of chronic symptoms, to maintain pulmonary function as near to normal as possible, to maintain normal activity, and to prevent exacerbations of the condition. In addition, medications used include: bronchodilators or other drugs in combination, such as corticosteroids or anticholinergics. Use of drugs called leukotriene modifiers act to block leukotriene which is a powerful bronchial constrictor. These modifiers are indicated for those patients who have mild, persistent asthma. Other treatment strategies include: avoidance of excessive exertion, cold air, or allergic agents, (e.g., dust, molds, pollen, and animal dander); and identification and elimination of causative factors.

Patients may have mild, moderate, or severe exacerbations. Some patients with sporadic episodes may have life-threatening occurrences separated by extended periods of no symptoms, mild symptoms, and normal pulmonary function. Depending on the severity of the condition, long-term therapy varies. Some patients require no daily treatment. Others may require several medications at relatively high doses for extended periods of time. Furthermore, persistent asthma (status asthmaticus) may require adrenocortical hormone treatment, which, with prolonged use, will lead to the development of serious side effects.

Note: In the absence of clinical findings of asthma at time of examination, a verified history of asthmatic attacks must be of record.