bronchospastic

Bronchospastic describes conditions or responses characterized by bronchospasm, the sudden constriction of bronchial smooth muscle that narrows the airways. This can produce wheeze, shortness of breath, coughing, and chest tightness. Bronchospastic responses are most common in asthma and are also seen with exercise-induced bronchospasm, allergies, infections, and irritants.

Pathophysiology involves airway smooth muscle constriction in response to inflammatory mediators, neural reflexes, and airway hyperresponsiveness. Inflammation releases histamine, leukotrienes, and other mediators that increase reactivity and mucus production. Chronic inflammation can lead to structural changes that promote recurrent bronchospasm.

Clinical features include wheezing, coughing, chest tightness, and variable dyspnea. Exam may reveal diffuse wheeze and prolonged expiration. Symptoms are often triggered by allergens, cold air, exercise, smoke, or respiratory infections.

Diagnosis relies on history and lung function testing. Spirometry typically shows reversible airway obstruction after bronchodilator administration. Peak expiratory flow variability can indicate control status. Bronchoprovocation testing with agents such as methacholine may be used when diagnosis is uncertain.

Management aims to prevent and treat bronchospasm. Acute episodes respond to inhaled short-acting beta-agonists; systemic steroids may be needed for severe symptoms. Long-term control uses inhaled corticosteroids, long-acting bronchodilators, and leukotriene modifiers, along with trigger avoidance and patient education. For exercise-induced bronchospasm, pre-exercise beta-agonists can help.

Prognosis depends on the underlying condition and adherence to therapy; many bronchospastic disorders are highly controllable with appropriate treatment.