About the Doctor 

Dr Vipin Aggarwal is a Pulmonologist practicing in East Delhi with 10 years of experience in this field. He practices at Max Super Speciality Hospital in Patparganj, Delhi, and runs a clinic at Laxmi Nagar, New Delhi.

He completed his MBBS from King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College in 2014 and MD - Tuberculosis & Respiratory Diseases/Medicine from Smt. Kashibai Naval Medical College and General Hospital in 2018. He excelled in the European Diplomate of Adult Respiratory Medicine in 2019.  

You can check his Practo profile here -> https://www.practo.com/delhi/doctor/vipin-aggarwal-pulmonologist/ 

Taking Control of Asthma

Asthma is a chronic lung condition characterised by coughing, wheezing, chest tightness and shortness of breath that may vary over time and in intensity. 

It is characterised by variable expiratory flow limitations, which can be objectively understood using instruments like a spirometer and peak expiratory flow meter.

It is different from its counterpart, COPD, by the presence of reversibility after administering a bronchodilator while performing this test. Asthma affects 5-10 % of the population globally. 

In India, according to the Global Burden of Disease, the number of people with asthma was estimated at 34.3 million in 2019, which is about 13.09% of the overall cases worldwide. 

But, the number of deaths in India comprises 42% of the total world’s mortality - a wide disparity from the global average caused by several factors -

  • Severe Air pollution 

Our cities are rated amongst the most polluted in the world, and the cities in the North—Delhi NCR, Varanasi, Agra—are amongst the most severely affected.

High levels of air pollution, particularly in urban areas, are a major trigger for asthma attacks. Particulate matter (PM2.5 and PM10), vehicular emissions, and industrial pollutants contribute significantly to respiratory problems.

  • Poor Access to Healthcare

With a per-capita income of less than $3000 and a severe shortage of essential medical personnel, it is no surprise that many Indians lack access to quality healthcare facilities, particularly in rural and low-income urban areas. 

These combinations of factors unique to the Indian context also lead to delayed diagnosis, inadequate treatment, and poor management of asthma symptoms, increasing the risk of fatal asthma attacks.

  • Allergens and Infections

High exposure to allergens such as dust mites, pollen, solid waste, pet fur, and frequent respiratory infections can trigger asthma attacks and worsen the condition.

  • Underdiagnosis and Undertreatment

There is a lack of awareness and education about asthma, leading to underdiagnosis and undertreatment. Many people do not recognise asthma symptoms or do not seek medical help until the condition becomes severe.

Most of our Indian population is under the pretence that their asthma is under control while still having symptoms subclinically. 

While the first 3 factors are not necessarily controllable at an individual level, the last one definitely is. 

With this blog, we hope to raise awareness of the symptoms patients should watch out for before rushing to a medical professional.

  • Severe Shortness of Breath

Persistent, severe difficulty breathing that doesn't improve with the use of bronchodilator/quick-relief inhaler.

  • Chest Tightness or Pain

This can indicate that your airways are significantly narrowed. If the chest tightness persists despite using an inhaler, it’s a cause for concern.

  • Severe Coughing or Wheezing

While mild coughing or wheezing is common in asthma, it is a sign of concern if it becomes continuous and severe.

  • Tachypnea

Rapid, shallow breathing indicates your body struggles to get enough oxygen.

  • Use of Accessory Muscles to Breathe

Visible use of neck, chest, or abdominal muscles to breathe. This suggests that the usual breathing muscles are insufficient, indicating significant respiratory distress.

  • Inability to Speak Full Sentences

Needing to take breaths between words or sentences. This is a sign that the airways are very constricted, and the lungs have insufficient air supply.

  • Cyanosis

A bluish or greyish colour around the lips, fingernails, or skin indicates low oxygen levels in the blood and requires immediate medical attention.

  • Anxiety or Panic

A feeling of impending doom or panic due to difficulty breathing. Severe asthma attacks can cause significant anxiety, which can exacerbate breathing difficulties.

  • Peak Flow Meter Readings

Peak expiratory flow (PEF) readings that are considerably below your normal levels. A drop to less than 50% of your normal or predicted peak flow reading suggests a severe asthma attack.

If you experience one or more symptoms, you should seek emergency medical help immediately. 

It's better to be cautious and consult a Pulmonologist, as asthma attacks can escalate quickly.