A bronchospasm is a cramping (medical term spasm) of the smooth part of the muscles of the bronchi. Bronchospasm often develops as a result of irritation of the airways, for example in the case of allergies or the ingestion of toxic substances. In addition, bronchospasm often occurs in so-called obstructive diseases of the lungs, such as asthma or COPD.
What is bronchospasm?
In connection with bronchospasm, the muscles in the area of the bronchi tense. These are primarily the smooth muscles that surround the airways. Various causes lead to the occurrence of a bronchospasm, for example contact with special vapors or an asthma illness.
As a result of the spasm, the muscles around the bronchi narrow. This reduces the width of the airways and increases breathing resistance. As a result, airway obstruction develops. For this reason there is also an association between bronchospasm and obstructive diseases of the lungs.
Due to the increased resistance to breathing, the lungs are either not supplied with enough air or they are over-inflated. If the bronchospasm lasts too long, hypertrophy develops in the muscles of the bronchi.
Bronchospasm is triggered by various potential influencing factors. In the majority of cases, these are external factors. For example, chemical or physical irritation can be a trigger. Certain types of medicinal substances are also able to provoke bronchospasm. These include primarily antibiotic agents that release the substance histamine, as well as opiates.
In addition, certain patient groups suffer particularly often from bronchospasm. The increased susceptibility to the phenomenon is primarily evident in people with asthma, acute respiratory diseases and smokers. People with COPD, certain allergies and allergic rhinitis are also particularly at risk.
In many cases, bronchospasm also arises when people inhale smoke or steam, for example. In addition, the bronchospasm may be triggered by operations in the area of the airways. Sometimes the cause of the bronchospasm is what is known as endotracheal intubation, which is performed with insufficient anesthesia.
Symptoms, ailments & signs
The symptoms of bronchospasm, as well as their severity, are different. Basically, with a bronchospasm, the bronchial areas or the surrounding smooth muscles constrict. As a result, an insufficient amount of air enters the affected person’s lungs. The patients initially suffer from shortness of breath.
Due to the sudden occurrence of this phenomenon, the sick often panic, so that hyperventilation follows. Because of the narrowed airways, an increase in the breathing rate is necessary in order to inhale the required air. If the air passes through the narrowed area, a whistling sound is produced when you exhale. In addition, the affected patients suffer from an insatiable cough.
In connection with this, people often throw out phlegm. As a result, breathing becomes even more difficult because the mucus blocks the airways. There is pain in the chest and airways. Many patients feel a lot of pressure or have the feeling of bruises in the chest area. The symptoms of bronchospasm usually worsen as the panic increases.
Movement and outbreaks of sweat often have a negative effect on the course of bronchospasm. In addition to the actual bronchospasm, there is also what is known as a simulated bronchospasm. This occurs, for example, when people inhale foreign substances, suffer from pulmonary embolism or edema, or when a ventilation tube is kinked.
Diagnosis & course
If the bronchospasm is severe, some people call the emergency doctor, who then makes the diagnosis. To determine the disease, the doctor orients himself on the typical symptoms of bronchospasm. Indications such as increased breathing resistance and characteristic noises when exhaling indicate bronchospasm.
In principle, rapid diagnosis and treatment of bronchospasm are of great importance. Because with long-lasting bronchospasm there is the risk of so-called hypercapnia, in the context of which the concentration of carbon dioxide in the blood is increased. In addition, hypoxia is possible, in which the tissue is no longer adequately supplied with oxygen.
Bronchospasm is caused by a variety of factors, which can have various complications. For example, people with an allergy are particularly prone to narrowing their airways. The airways swell up due to a certain substance and this leads to an obstruction, the affected person can hardly breathe and threatens to suffocate. Because of its anatomical proximity to the esophagus, it also becomes difficult to swallow.
In addition, due to the allergic reaction, the deeper layers of the skin can swell strongly, resulting in Quincke’s edema, which can make the symptoms even worse. In the worst cases there is a sharp drop in blood pressure, as a result of which several organs are no longer adequately supplied with blood, resulting in an anaphylactic shock. The organs can fail as a result and present further problems for the person concerned.
Similar complications can occur with asthma. Above all, the status asthmaticus is feared, with which even antiasthmatics do not help and the person concerned threatens to suffocate. An emergency doctor should be notified immediately.
A respiratory infection can also cause bronchial constriction. In some cases, the inflammation can spread to the lungs and trigger inflammation there (pneumonia). In the worst cases, the inflammation can spread systemically, i.e. sepsis.
When should you go to the doctor?
A new bronchospasm should always be clarified by a doctor, as it is the symptom of many chronic and acute ailments. In addition, fake bronchospasm can indicate damage to the lungs or air in the pleural cavity.
The actions of those affected are largely determined by the effects of the spasm. If it is a minor restriction with shortness of breath and coughing that passes again, an emergency doctor is not necessary. Sufferers should find a resting position in which they can cough up and see a doctor when the bronchospasm has subsided.
A bronchospasm, which leads to pain and severe shortness of breath, may make it necessary to call an emergency doctor. There are bronchospasms, which are further intensified by the onset of hyperventilation, mucus formation and cramping, and which bring with them the risk of suffocation.
People with chronic illnesses that tend to cause airway spasms to experience it more often. If you have an episode, you have to assess for yourself whether it is necessary to call an emergency doctor. However, if the generally perceived condition of the airways worsens due to frequent or severe spasms, a medical clarification with the attending physician is necessary.
Treatment & Therapy
The options for treating bronchospasm vary, with the decision for certain measures depending on the severity of the bronchospasm in particular. It is possible, for example, for the affected patients to be ventilated manually. As a result, they receive high concentrations of oxygen.
If the bronchospasm occurs as part of a surgical procedure, stronger anesthesia may help the person. Anesthetic agents such as ketamine are suitable for this purpose. So-called beta-2 mimetics are able to widen the bronchi and relieve the symptoms of bronchospasm.
Outlook & forecast
Bronchospasm has a favorable prognosis with rapid medical care. With a drug treatment, the symptoms will be relieved within a short time. The cramps in the muscles are released so that the person concerned can breathe normally again. If there are no other basic or secondary symptoms, there is no symptom.
The bronchospasm can recur at any time. The more it occurs, the greater the risk of further damage. The prospect of a cure worsens significantly once the patient is compromised from a chronic lung disease.
In these cases, tissue damage has already occurred that leads to irreparable development. In addition to breathing difficulties, functional disorders can occur or there is a risk of organ failure. This is associated with a life-threatening condition for the patient. The only thing the patient can do at this stage is an organ transplant, which in turn is associated with side effects and risks.
The sudden onset of bronchospasm can develop an anxiety disorder. The muscle spasms lead to unexpected shortness of breath. This triggers the fear of death by suffocation. A panic attack or panic disorder can also develop. This has an immense influence on the general feeling of health. The insufficient supply of oxygen to the organism can also trigger secondary diseases and thus negatively affect the chances of recovery.
A bronchospasm can be prevented to a certain extent, although cases of illness cannot be completely avoided even with preventive measures. People at increased risk of bronchospasm are given certain preventive drugs before surgery. Beta-2 mimetics are used here. If possible, the treating physicians only numb the area to be operated on regionally as part of a surgical procedure.
After a bronchospasm has occurred, there are usually no further symptoms. The patient can breathe normally again and go about his life. Quick, immediate aid proves to be beneficial for recovery. Follow-up care is unnecessary. However, there is no immunity.
A recurring illness for the same or another reason is possible at any time. In principle, an increased occurrence requires continuous follow-up care, because the likelihood of chronic damage increases. The doctor determines an acute condition based on the typical breathing difficulties.
So far there are hardly any ways to prevent bronchospasm. It often occurs in combination with other respiratory diseases. Endangered patients are informed about health-preserving behavior as part of the initial therapy. This includes, above all, protection. Strenuous activities should be avoided at all costs. A healthy and balanced diet is advisable. The consumption of nicotine should be stopped.
Follow-up care also aims to rule out complications. Patients at risk include allergy sufferers and asthmatics. Medication for shortness of breath and shortness of breath can help. Regular use reduces the likelihood of spasms in the bronchial muscles. Only minor restrictions have to be accepted in professional and private life.
You can do that yourself
If a bronchospasm is suspected, the emergency services must be called immediately and informed about the situation using the W questions. Before the emergency doctor arrives, first aid measures must be taken.
The first thing to do is to calm the patient down, provide them with warm blankets and loosen tight clothing. The upper body must be positioned upwards and the legs must be positioned low. If the affected person is asthmatic, appropriate asthma medication should be used to treat bronchospasm. In the event of unconsciousness, the person concerned must be brought into the stable side position.
If possible, breathing and pulse should be checked regularly afterwards. If necessary, resuscitation measures must be taken. In addition to mouth-to-mouth resuscitation, cardiopulmonary resuscitation and – assuming the appropriate specialist knowledge – an incision in the trachea are recommended. The emergency doctor must be informed about the measures taken and the patient’s state of health in order to ensure rapid treatment.
After the treatment in the hospital, the person concerned initially has to rest in bed and rest. In addition, the causes of the bronchospasm must be determined. This and a consultation with your family doctor can in most cases avoid further attacks.