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For most of us, exercise leaves us breathless. But for a person with a chronic asthma, even a moderate workout can leave him or her gasping for air. Asthma attacks can be frightening, and most people are rarely well-prepared to cope with them.

If, after exercise, your lungs feel congested and you have difficulty breathing, you may be one of the thousands of people who experience exercise-induced asthma. This condition occurs most frequently among people with chronic asthma. However, some individuals who have no medical history of asthma also experience EIA.Symptoms associated with exercise-induced asthma are identical to those of chronic asthma. But, as it name implies, this condition is brought on by exercise. Many who have this condition believe that their only position for either competitive or recreational sports is on the sidelines watching rather than participating.

This is not always the case. Those with EIA can often participate in recreational sports or even competitive athletics. The reason is that there is better understanding of EIA and how exercise and overall fitness can enhance performance.

Causes of EIA

Exercise-induced asthma is the result of bronchospasm (contraction of the muscle fibers that line the smaller airways), fluid accumulation and inflammation within the lungs. As the bronchial tubes constrict, they block airflow. At first, the obstruction of airflow is greater when air is exhaled. It causes wheezing - a high-pitched whistling sound. As breathing becomes more difficult, a feeling of tightness in the chest and coughing develops.

The symptoms may begin during strenuous activity or, for some, three to six hours after exercising. Most attacks go away by themselves within 45 to 60 minutes.

During exercise, a person breathes two to three times faster than while at rest. Therefore, the lungs must humidify and heat large volumes of air in a relatively short amount of time. When a person breathes faster, the airways lose more water by evaporation and, consequently, more heat. This loss of both heat and water cools the bronchial tubes. This leads to their narrowing after exercise.

The heat and water loss also may cause release of histamine - an important component of allergic reactions - and, possibly, other chemicals stored within the mast cells of the lungs. These chemicals can affect the involuntary muscles surrounding the bronchial tubes and consequently trigger EIA.

Controlling EIA

Even though exercise can lead to an asthma attack, regular, moderate activity can actually benefit some asthma sufferers and reduce EIA attacks among individuals who do not suffer from chronic asthma.

Here are some considerations to help manage those with EIA:

- Type of activity. Some sports are less apt to prompt EIA attacks than others. Indoor swimming, for example, is least likely to cause EIA because of the warm, humid environment. On the other hand, running is the most likely to cause EIA, especially if done in cold, dry air. If you do run in cold weather, wear a face mask. This helps you rebreathe warm air and small amounts of exhaled carbon dioxide, which may dilate the bronchial tubes.

- Physical condition. Stay physically fit with regular, moderate workouts.

- Warmup. A warmup routine before working out can mildly dilate the airways to ease breathing and improve performance. Some competitive athletes actually use a vigorous warmup to produce an EIA attack. Then, for the next two to three hours, strenuous competition may lesson their asthma symptoms.

- Medications. Several medications now are available to control or block exercise-induced asthma. Taken regularly before exercise, they may allow full participation in both recreational and competitive sports.

First aid

If you encounter a person coughing, complaining of chest tightness, wheezing when exhaling and has shortness of breath, then proceed as follows:

1. Ask if the victim has medication prescribed by a physician (usually a nebulizer/inhaler).

2. Assist the victim in taking his or her medicine.

3. Some victims may have a peak flow meter with them and know what readings indicate worsening asthma. Higher readings mean the airway is opening and asthma is getting better. Lower readings mean the airway is tightening and asthma is getting worse.

4. If signs and symptoms get worse or don't improve within 15-30 minutes after taking the medication, then seek medical attention.