Describe an asthma attack


What Are the Symptoms of Asthma?

Asthma is a chronic disease that inflames the airways. This means that people with asthma generally have inflammation that is long lasting and needs managing. An asthma episode, also called an asthma flare-up or asthma attack, can happen at any time. Mild symptoms may only last a few minutes while more severe asthma symptoms can last hours or days.

Common symptoms of asthma include:

  • Coughing
  • Wheezing (a whistling, squeaky sound when you breathe)
  • Shortness of breath
  • Rapid breathing
  • Chest tightness

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What Are the Signs of a Severe Asthma Attack?

Asthma may lead to a medical emergency.

Rescue inhalers can help you: otc inhalers

Seek medical help immediately for:

  • Fast breathing with chest retractions (skin sucks in between or around the chest plate and/or rib bones when inhaling)
  • Cyanosis (very pale or blue coloring in the face, lips, fingernails)
  • Rapid movement of nostrils
  • Ribs or stomach moving in and out deeply and rapidly
  • Expanded chest that does not deflate when you exhale
  • Infants with asthma who fail to respond to or recognize parents

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What Happens During an Asthma Episode?

During normal breathing, the airways to the lungs are fully open. This allows air to move in and out of the lungs freely. Asthma causes the airways to change in the following ways:

  1. The airway branches leading to the lungs become overly reactive and more sensitive to all kinds of asthma triggers
  2. The linings of the airways swell and become inflamed
  3. Mucus clogs the airways
  4. Muscles tighten around the airways (bronchospasm)
  5. The lungs have difficulty moving air in and out (airflow obstruction: moving air out can be especially difficult)

These changes narrow the airways. Breathing becomes difficult and stressful, like trying to breathe through a straw stuffed with cotton.

Why Does My Asthma Act Up at Night?

Uncontrolled asthma — with its underlying inflammation — often acts up at night. It probably has to do with natural body rhythms and changes in your body’s hormones. The important thing to know about nighttime asthma is that, with proper management, you should be able to sleep through the night.

How Is Asthma Prevented and Treated?

There is no cure for asthma. Control symptoms by taking asthma medicines and avoiding your triggers. With proper treatment and an asthma management plan, you can reduce your symptoms and enjoy a better quality of life.

Talk to your health care provider about your asthma symptoms and be sure to discuss any changes in your asthma management or status.

Medical Review September 2015.

Only people who have asthma fully understand how traumatizing this health condition can be. If someone has asthma, their immune system reacts disproportionately to certain substances like pet dander or pollen, though specific triggers vary from person to person. These triggers provoke inflammation, constriction, and excessive mucus production in a person’s airways, which can lead to symptoms like shortness of breath, coughing, chest pain, and wheezing (an alarming whistling sound during breathing).

For a glimpse into the reality of life with this health issue, we had people who have been through asthma attacks explain exactly what they feel like, plus what they do when their asthma symptoms flare up.

1. “It can feel like I’m breathing through a squished straw.”

Kate G. was diagnosed with asthma after an outdoor excursion. “I started wheezing partway up the mountain while hiking during a school field trip,” Kate, whose main triggers include physical exertion, smoke, mold, mildew, dust, cold air, and pet dander, tells SELF.

During an asthma attack, she says, “it feels like someone or something is sitting on my chest and constricting my lungs so I can only breathe in partway. It can feel like I’m breathing through a squished straw.” Sometimes she experiences feelings of panic, lightheadedness, and chest pain.

To get relief, Kate uses a fast-acting inhaler with medication to quickly open her constricted airways. (This kind of medication is called a bronchodilator.) “If I’m not near my inhaler, which is rare, I go outside and try to breathe deeply and slowly,” she says. “Lying down also helps.”

2. “It feels like someone is squeezing the air out of me.”

Kay M. had her first attack at home next to a Christmas tree, she says. “I have an allergy to evergreen trees, I later found out, and I just started gasping for air,” she tells SELF. “It starts out with a little chest tightness, and then it just keeps on going it feels like someone is squeezing the air out of me.”

Kay uses a daily, long-term medication to keep her airways dilated and prevent attacks, as well as a fast-acting inhaler as needed.

3. “I try to yawn to get more air in, and my chest literally stops the yawn from happening because it’s so tight and inflamed.”

Paige J. says that her triggers include exposure to pollen, dust, and animals like cats and dogs. “I can be fine around a dog or cat for minutes or even hours at a time during the day, but later that night I’ll wake up with terrible asthma and tightness of my chest,” she tells SELF. “It’s important that family and friends realize this, because those around you can’t always see your symptoms and thus might not always take them seriously.”

In fact, Paige often gets quiet during asthma attacks. “Talking can feel like too much effort … I become 100 percent absorbed in just trying to breathe, but this often doesn’t look like a big deal from the outside,” she says. On the inside, though, she’s dealing with the terrible feeling that her lungs aren’t working. “I try to yawn to get more air in, and my chest literally stops the yawn from happening because it’s so tight and inflamed.”

Paige says she usually carries her rescue inhaler with her, but if for some reason she doesn’t have it, she tries to get fresh air, drink coffee, or eat dark chocolate. (There’s some evidence that caffeine can act as a bronchodilator, but you should only use it as a method of treating asthma symptoms in certain situations if your doctor has included it in your asthma action plan.)

4. “It starts with a cough that seems to be centered in my throat because there is no air getting into my lungs.”

Victoria B., whose triggers include mold and a food allergy to turkey, says that a cough often kicks off her asthma attacks. “It starts with a cough that seems to be centered in my throat because there is no air getting into my lungs,” she tells SELF. “Very shortly thereafter, the coughing stops and I start to wheeze. It gets harder to breathe and my chest starts to hurt.”

Types, causes, and diagnosis of asthma

Asthma can occur in many different ways and for many different reasons, but the triggers are often the same. They include airborne pollutants, viruses, pet dander, mold, and cigarette smoke.

The sections below list some common types of asthma.

Childhood asthma

Asthma is the most common chronic condition in children. It can develop at any age, but it is slightly more common in children than in adults.

In 2017, children aged 5–14 years were most likely to experience asthma. In this age group, the condition affected 9.7% of people. It also affected 4.4% of children aged 0–4 years.

In the same year, asthma affected 7.7% of people aged 18 years and over.

According to the American Lung Association, some common triggers of childhood asthma include:

  • respiratory infections and colds
  • cigarette smoke, including secondhand tobacco smoke
  • allergens
  • air pollutants, including ozone and particle pollution, both indoors and outside
  • exposure to cold air
  • sudden changes in temperature
  • excitement
  • stress
  • exercise

It is vital to seek medical attention if a child starts to experience asthma, as it can be life threatening. A doctor can advise on some of the best ways to manage the condition.

In some cases, asthma may improve as the child reaches adulthood. For many people, however, it is a lifelong condition.

Adult-onset asthma

Asthma can develop at any age, including during adulthood. According to one 2013 study, adults are more likely than children to have persistent symptoms.

Some factors that affect the risk of developing asthma in adulthood include:

  • respiratory illness
  • allergies and exposure to allergens
  • hormonal factors
  • obesity
  • stress
  • smoking

Learn more about adult-onset asthma here.

Occupational asthma

Occupational asthma results from exposure to an allergen or irritant present in the workplace.

In the following workplaces, allergens may cause asthma in those with a sensitivity or allergy:

  • bakeries, flour mills, and kitchens
  • hospitals and other healthcare settings
  • pet shops, zoos, and laboratories where animals are present
  • farms and other agricultural settings

In the following occupations, irritants can trigger asthma symptoms:

  • car repairs and manufacturing
  • engineering and metalwork
  • woodwork and carpentry
  • electronics and assembly industries
  • hairdressing salons
  • indoor swimming pools

Those with a higher risk include people who:

  • smoke
  • have allergic rhinitis
  • have a history of asthma or environmental allergies

A person’s work environment can trigger a return of childhood asthma or the start of adult-onset asthma.

Difficult-to-control and severe asthma

Research suggests that around 5–10% of people with asthma have severe asthma.

Some people have severe symptoms for reasons that do not relate directly to asthma. For example, they may not yet have learned the correct way to use an inhaler.

Others have severe refractory asthma. In these cases, the asthma does not respond to treatment — even with high dosages of medication or the correct use of inhalers. This type of asthma may affect 3.6% of people with the condition, according to one 2015 study.

Eosinophilic asthma is another type of asthma that, in severe cases, may not respond to the usual medications. Although some people with eosinophilic asthma manage with standard asthma medications, others may benefit from specific “biologic” therapies. One type of biologic medication reduces the numbers of eosinophils, which are a type of blood cell involved in an allergic reaction that can trigger asthma.

Learn more about severe asthma here.

Seasonal asthma

This type of asthma occurs in response to allergens that are only in the surrounding environment at certain times of year. For example, cold air in the winter or pollen in the spring or summer may trigger symptoms of seasonal asthma.

People with seasonal asthma still have the condition for the rest of the year, but they usually do not experience symptoms.

Asthma does not always stem from an allergy, however. Learn more about the difference between allergic and nonallergic asthma here.

How Asthma Affects Your Body

Asthma is a disease that affects the airways of your lungs. With asthma, your airways’ lining tends to always be in a hypersensitive state characterized by redness and swelling (inflammation). It’s similar to how your skin becomes red, irritated and sensitive after a sunburn. This hypersensitive state makes the airways react to things that you are exposed to every day, or asthma “triggers.” A trigger could be the common cold, stress, changes in the weather, or things in the environment, such as dust, chemicals, smoke and pet dander. Learn more about how the air we breathe plays a role in our health.

Asthma Flare-Ups

When you experience a trigger, the insides of your airways swell even more. This narrows the space for air to move in and out of the lungs. The muscles that wrap around your airways also can tighten, making breathing even harder. When that happens, it’s called an asthma flare-up, asthma episode or asthma “attack.”

After an asthma flare-up, you probably will feel tired. You’re also at greater risk of having another flare-up for several days after an episode. For the days following a flare-up, be sure to:

  • Avoid your asthma triggers
  • Monitor your symptoms or check you airways using a peak flow meter

Airway Remodeling

Poor asthma management can lead to airway remodeling. Airway remodeling is a serious condition that happens when asthma is untreated or poorly managed. The lungs become scarred, asthma medicines do not work as well and less air is able to move through your airways. Airway remodeling does not have to happen. Work with a healthcare professional to minimize asthma flare-ups and find a treatment plan that works for you. Take control of your asthma!

Could I have severe asthma?

When your asthma is well-controlled, you experience very few symptoms throughout the day and night and you can perform daily activities without shortness of breath, chest tightness, coughing or wheezing. Some people have asthma that is difficult to treat or does not respond well to inhaled corticosteroids. Depending on the type of asthma that you have, there are different management steps and treatment options that can help. Learn more about severe asthma.

What Is Asthma?

Watch the video and get key facts about asthma.

Dealing With an Asthma Flare-Up

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What’s an Asthma Flare-Up?

An asthma flare-up is when asthma symptoms get worse, making someone wheeze, cough, or be short of breath. An asthma flare-up can happen even when asthma is controlled.

Asthma flare-ups are also called asthma attacks or exacerbations.

Triggers like allergies, respiratory infections (like a cold), cigarette smoke, exercise, or even cold air can cause a flare-up and make asthma symptoms worse.

What Happens During an Asthma Flare-Up?

During a flare-up, you might have:

  • trouble breathing
  • a tight chest
  • a whistling sound when you breathe (wheezing)
  • a cough

Flare-ups happen when the airways in the lungs get more irritated and swollen than usual. Your lungs might make a sticky mucus, which clogs the airways. The muscles around the airways will also tighten up, making them really narrow. This clogging and narrowing make it tough to pull air in and push air out.

Some flare-ups are mild, but others are serious. If the flare-up is severe, a person might:

  • struggle to breathe or have fast breathing even when sitting still
  • not be able to speak more than a few words at a time without pausing
  • have retractions (sucking in of muscles in the neck and chest) while breathing in

Flare-ups can happen suddenly. They also can build up over time, especially if you haven’t been taking your asthma medicine.

How Can I Spot an Asthma Flare-Up?

After you’ve had a few flare-ups, you may notice that you feel a certain way when one is coming on. Do you have a tight chest or an itchy throat? Are you feeling tired? Do you have a cough, even though you don’t have a cold?

How Do I Handle an Asthma Flare-Up?

If you feel like a flare-up is about to happen, stay calm. Let people around you know what’s going on. Then remember your asthma action plan. That’s the written plan that tells you what to do next.

Stay calm and focus on what your asthma action plan says. Your doctor probably told you to use your quick-relief medicine, so do that first.

If you can figure out what triggered your symptoms (like a pet or someone who is smoking), remove the trigger — or yourself — from the area. Sometimes that’s all you need to get your asthma under control again.

If a flare-up is more severe, you might need to get help.

When Should I Go to the ER?

Don’t be embarrassed to get medical help if you think you need it. These situations call for emergency care:

  • You take your asthma medicine and your flare-up doesn’t get any better.
  • You feel a little better after taking your medicine, but your symptoms come back quickly.
  • You have frequent wheezing, a lasting cough, or chest pain.
  • Your lips and fingernails are bluish or grayish.
  • You have trouble breathing, talking, or walking.

How Can I Prevent Asthma Flare-Ups?

Asthma flare-ups can be handled, but it’s even better if you can prevent them from happening. To do that:

  • Take asthma medicines as directed. If your doctor prescribed a long-term control medicine, take it each day, even when you feel fine. It needs to be taken exactly as your doctor tells you to keep protecting you against flare-ups.
  • Get a flu shot each year before flu season starts.
  • Avoid triggers. By knowing and avoiding your triggers, you might be able to prevent some flare-ups.

It’s important to plan ahead and know what to do. Work with your doctor to build and update your asthma action plan. That way, you know what to do if a flare-up happens and you’re in control if things get serious.

Reviewed by: Aledie Amariah Navas Nazario, MD Date reviewed: August 2018

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