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Silent Asthma

Lung inflammation causes the airways to narrow in people with asthma. Coughing and wheezing are common symptoms, and it makes breathing difficult.

What is Silent Asthma?

Silent asthma is a form of asthma where the typical symptoms like wheezing and coughing are absent. Instead, people with silent asthma experience subtle symptoms that are easy to overlook, such as:

  • Shortness of breath, especially with exertion
  • Chest tightness or a feeling of heaviness in the chest
  • Frequent respiratory infections that are hard to shake
  • Fatigue and difficulty sleeping

Silent asthma can be dangerous because the lack of obvious symptoms may delay diagnosis and treatment. Over time, untreated asthma can worsen and lead to permanent lung damage.

Silent Chest

In severe cases, silent asthma can progress to a life-threatening condition called status asthmaticus or a “silent chest”. With a silent chest, the airways become extremely constricted, causing a sudden lack of audible breath sounds. This is an emergency requiring immediate medical treatment to restore breathing and prevent respiratory failure.

Silent asthma

Symptoms of Silent Asthma

While wheezing and coughing are not common symptoms of silent asthma, the symptoms of an attack are similar in those with typical asthma:

  • Difficulty while breathing
  • Tightness in the chest
  • Anxiety or distress
  • Fatigue
  • Speaking with difficulty

The following are severe symptoms that call for immediate medical attention:

  • noticeable “sucking in” of the skin between the ribs and at the base of the neck (caused by the breathing muscles working extremely hard)
  • Breathing quickly
  • lightheadedness or unconsciousness
  • difficulty breathing, making it difficult to speak
  • Cyanosis, which is caused by low oxygen levels, causes the lips, tongue, or nail beds to turn blue or whitish/grayish

Factors causing Silent Asthma

There are some factors that can worsen silent asthma such as;

  • Allergens like pollen, dust, dander of pets, moulds etc.
  • Cold air or abrupt weather variations
  • Stress on an emotional level
  • Exercise increases the need for oxygen because it
  • Disease of gastric reflux
  • Changes in hormones
  • Air pollution, smoke, strong odors, and chemical fumes are examples of irritants.
  • Infections of the respiratory system

Risk factors for Silent Asthma

There are several key risk factors for developing asthma:

  • Family history and genetics: If one or both parents have asthma, you are 3-6 times more likely to develop it. Multiple genes are thought to be involved in asthma development.
  • Allergies: Having allergic conditions like eczema or hay fever increases asthma risk. Sensitivity to allergens like dust mites, pet dander, mold, pollen, and certain foods can trigger asthma attacks.
  • Sex and age: Asthma is more common in children, especially boys. Around age 20, the ratio between men and women is equal.
  • Environmental exposures: Cigarette smoke, air pollution, chemicals, gases, and occupational allergens can increase asthma risk. Viral respiratory infections, especially in childhood, are also linked to higher risk.
  • Obesity: Both overweight children and adults have an increased risk of developing asthma, possibly due to low-grade inflammation.
  • Other factors: Premature birth, low birth weight, obesity, and maternal smoking during pregnancy are additional risk factors. After age 40, more females have asthma.

Treatment for Silent Asthma

To effectively treat asthma, various medications and strategies are available.

  • Medications commonly used include bronchodilators, which can be short-acting for immediate relief during an asthma attack or long-acting for symptom management over time.
  • Inhaled corticosteroids are essential for long-term control, reducing airway inflammation and mucus production.
  • Additionally, leukotriene modifiers and theophylline are used as long-term treatments to prevent asthma attacks.
  • For severe cases not responding to standard medications, biologics like Omalizumab (Xolair) can be considered.
  • Lifestyle changes such as dietary adjustments, exercise, and stress management can also help manage asthma symptoms.

Asthma ICD 10 codes

The ICD-10 codes for asthma provide detailed classification based on severity and characteristics. In ICD-10, asthma is categorized as intermittent or persistent, with descriptors such as mild, moderate, and severe. The codes include:

  • 2x for mild intermittent asthma
  • 3x for mild persistent asthma
  • 4x for moderate persistent asthma
  • 5x for severe persistent asthma
  • 90x for unspecified asthma

Additional codes cover specific conditions related to asthma, like exercise-induced bronchospasm and cough variant asthma. These codes are essential for accurate diagnosis and treatment of asthma.

End Note

Silent asthma is a severe form of asthma that can be life-threatening because it lacks the typical symptoms like wheezing and coughing that indicate an asthma attack. Silent asthma is difficult to diagnose since it lacks the typical audible signs. Doctors may need to conduct tests like spirometry, peak flow measurements, or bronchoprovocation to assess lung function and airway inflammation. Maintaining asthma medication and being aware of subtle symptoms is important to prevent silent asthma attacks.

FAQ’s

1: Is asthma a disability?

Asthma is legally considered a disability, only the most severe, uncontrolled cases that significantly impair one’s ability to work are likely to qualify for disability benefits. Milder asthma that can be managed with medication usually does not meet the SSA’s (Social Security Administration) strict criteria.

2: Is asthma an autoimmune disease?

No, asthma is not an autoimmune disease. While asthma and autoimmune diseases both involve the immune system, they are distinct conditions with different underlying mechanisms.

Asthma is an inflammatory condition characterized by chronic inflammation and narrowing of the airways in response to specific triggers like allergens or irritants. The immune system plays a role in this inflammatory response, but asthma is not caused by the immune system attacking the body’s own tissues, which is the defining feature of autoimmune diseases.

In contrast, autoimmune diseases occur when the immune system mistakenly attacks healthy cells and tissues in the body. Examples include rheumatoid arthritis, lupus, type 1 diabetes, and multiple sclerosis. Autoimmune diseases are chronic and progressive, while asthma symptoms can be intermittent and may improve over time.

3: Can Covid cause asthma?

COVID-19 can potentially lead to the development of asthma in some individuals. Recent studies have indicated that there may be a link between COVID-19 infection and the onset of asthma, particularly in adults. Research suggests that recent COVID-19 infection may rarely cause asthma, possibly associated with eosinophilic inflammation. A study found that out of patients who had recovered from COVID-19, a small percentage developed new-onset asthma after the infection, with COVID-19 infection being associated with higher odds of developing new-onset asthma. Additionally, people with asthma who have had COVID-19 commonly report increased reliever inhaler use and poorer asthma management, with persisting symptoms being common following COVID-19 in individuals with asthma.

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