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Correct Answer: bronchoconstriction, edema of the
bronchi/bronchioles, and mucus congestion.
during an asthmatic attack, several pathological changes occur in the respiratory system that lead to the typical symptoms of asthma such as wheezing, shortness of breath, chest tightness, and coughing. these changes primarily affect the airways, particularly the bronchi and bronchioles, which are the smaller tubes that air passes through in the lungs.
the first major change is bronchoconstriction. this occurs when the smooth muscles that surround the airways tighten and contract, narrowing the diameter of the airways. this contraction is often a response to various triggers including allergens, cold air, exercise, or irritants in the environment. the narrowing of the airways makes it harder for air to flow in and out, leading to breathing difficulties.
alongside bronchoconstriction, there is also inflammation and swelling of the airway walls, referred to as edema. this inflammation is typically a response of the immune system to perceived threats. chemical mediators released during the inflammatory response increase the permeability of blood vessels, leading to leakage of fluid into the tissues of the airway walls. this contributes further to the narrowing of the airways and exacerbates breathing difficulties.
mucus production is another significant change during an asthma attack. the cells lining the airways produce excessive mucus in response to the inflammatory process. this mucus is thicker than normal and can obstruct the airways, compounding the effects of bronchoconstriction and edema. the increased mucus can also trigger coughing as the body attempts to clear the airway passages.
these changes—bronchoconstriction, edema, and mucus congestion—are usually reversible with appropriate treatment, such as the use of bronchodilators which help to relax the airway muscles and anti-inflammatory medications that reduce swelling and mucus production. however, if asthma attacks are frequent and chronic inflammation persists, these changes can lead to more permanent structural alterations in the airways, such as airway remodeling. this can result in a long-term decline in lung function and more persistent symptoms.
in summary, the main pathological changes during an asthma attack involve a combination of airway narrowing due to muscle contraction, swelling due to inflammation, and blockage due to increased mucus production. understanding and managing these changes are crucial for effective asthma control, especially in a patient with other underlying conditions such as cardiac myopathy, as in the case described.
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