DrJohnHong.com

Asthma

Asthma is chronic inflammatory disorder of the airways of the lungs. 75% cases diagnosed before age 7.  For many, remission occurs during puberty but comes back later.  Usually doesn’t develop after age 50.  The airways close up so exhaling becomes difficult. Symptoms: intermittent sob, cough, wheezing, chest tightness.  Usually worse at night and/or early a.m.  Symptoms go away after time or with treatment, so reversibility is easier than with COPD.   Wheezing usually occurs exhaling, not as much with inhaling (this is called stridor), that is a high-pitched whistle sound.  Cough is dry or wet (pale yellow or mucoid).  Chest tightness from the airways closing up: band-like constriction.  Exacerbating factors cause the inflammation of the airways.  Allergens are a big factor: mold, pollen, dust, furry animals, cockroaches, smoke, fumes, mite poop. Cold air can trigger off asthma attack. Exercise induced asthma – 10-15min after exercise asthma attack occurs.   Change in weather.  Viral and bacterial illness.  Postnasal drip and GERD.   Many will have allergies of the skin (eczema) and/or allergic rhinitis (nose allergies).  Nasal polyps can be a sign person has asthma, and in this aspirin can make it worse.  Occupational exposures.

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Heart Attack (Acute Coronary Syndrome)

Myocardial Infarction (MI) is a “heart attack” in which heart muscle doesn’t get enough blood/oxygen and dies.  Main cause is from a coronary artery getting blocked by a clot that forms on an atherosclerotic plaque (called acute coronary syndrome (ACS) that occurs abou 1,200,000 times a year).  38% die each year from ACS (450,000 people).  That is 1 in every 5 deaths making coronary heart disease (CHD) #1 cause of death in USA. 16 million Americans have CHD.  ½ millions new cases of stable angina a year.

ACS: Chest pains aren’t pain – squeezing of the chest, heaviness like an elephant standing on the chest. Under the sternum more than 15 minutes. 20min heart muscles die. Radiation of discomfort like a numbness to neck, jaw, shoulder, down left arm, maybe back.  N, SOB, palpitations, lightheadness, sweating.  Often occurs with exertion though can occur at rest especially with h/o angina.

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