When Asthma Attacks

PART 1 Symptoms of Asthma

The symptoms of asthma vary widely between individuals. The four major recognized asthma symptoms are:

Coughing spells, usually worse at night and early in the day, sometimes while laughing. Coughing may or may not produce phlegm. It’s usually worse after exercise or exposure to cold, dry air. Coughing may be the only symptom of asthma an individual has.

Shortness of breath that worsens with exercise or activity or at night

Wheezing, especially when exhaling

Feelings of tightness or pain in the chest

Other symptoms of asthma include:

Prolonged exhalation when breathing (breathing out takes at least twice as long as breathing in)

Nasal flaring

Breathing stops temporarily

Intercostal retractions (pulling in of the skin between the ribs when breathing)

LESS

PART 2 What Is an Asthma Attack?

Asthma attacks, also called flare-ups or exacerbations, are a sudden worsening of asthma symptoms.

What’s considered an asthma attack varies between individuals, depending on the type and severity of their symptoms. The severity of someone’s symptoms depends on how well their asthma is being controlled—that is, how much the chronic airway inflammation that characterizes asthma is being kept under control. Some people have only mild symptoms of asthma. In fact, they might have no symptoms at all most of the time and only occasionally experience episodes of shortness of breath, for instance, or of coughing. For these people, such transient, mild symptoms are considered asthma attacks. READ MORE

Other people may have chronic symptoms of asthma, such as coughing and wheezing. (“Chronic” means that they experience these symptoms almost all the time.) For these people, an asthma attack may include the worsening of their chronic symptoms as well as new symptoms, like chest pain and shortness of breath. LESS

PART 3 Symptoms of Asthma Attack

Symptoms of asthma attack often include:

Coughing

Shortness of breath

Wheezing, especially when exhaling

Chest tightness or pain

Rapid heart rate

Sweating

Other symptoms of asthma attack may include:

Itching on the chest or neck, especially in children

Prolonged exhalation when breathing (breathing out takes at least twice as long as breathing in)

Nasal flaring

Temporary cessation of breathing (breathing stops temporarily)

Intercostal retractions (pulling in of the skin between the ribs when breathing)

LESS

PART 4 Severe Asthma Attack

An asthma attack may proceed very slowly to a severe condition, or it may become serious very quickly, even within a matter of minutes. In a severe asthma attack, the person can only say a few words without stopping to take a breath. Wheezing and coughing may cease because there is hardly any air moving in and out of the lungs. The person having the attack may be confused and lethargic, and his or her skin may turn blue due to lack of oxygen. READ MORE

A severe asthma attack is especially dangerous because it doesn’t respond to inhaled bronchodilators, the usual quick-relief medications. Emergency treatment, either at a hospital emergency room or at an asthma specialist’s office, is vital in this situation. If the person doesn’t get treatment at this point, there is a chance the asthma will develop into status asthmaticus, a potentially fatal condition. Fortunately, with treatment most people are able to recover completely from a severe attack. LESS

PART 5 Status Asthmaticus

The most severe form of asthma attack is termed status asthmaticus. In it, the airways are so narrowed that it’s very difficult for any air to move into or out of the lungs. Oxygen can’t reach the body’s tissues, so organs begin to malfunction. Because it can’t be removed by the lungs, carbon dioxide begins to build up in the blood. This leads to a condition called acidosis, in which the blood becomes overly acidic. Acidosis disturbs the functioning of almost every organ in the body. The person’s blood pressure begins to fall. READ MORE

Emergency treatment for status asthmaticus includes intubation, inserting a tube through the mouth and into the airways for mechanical ventilation, as well as giving maximum doses of a number of different drugs. LESS

PART 6 When Do Asthma Attacks Occur?

What Do You See?

It’s the monster that lives in your pillow...

In about 75% of people with asthma, attacks occur at night or in the very early morning (termed nocturnal asthma). Often an asthma attack will occur shortly after exposure to a trigger. This is termed an acute asthma attack, and it generally ends within an hour. In about half of those who have an acute attack, a second attack, termed late phase response, develops in 3-8 hours. This second attack leads to further inflammation of the airways and obstruction of airflow.

An asthma attack can last anywhere from minutes to days.

Photo credit: Living room
Copyright 2009 Nate Grigg

Photo credit: Nonsteroidal anti-inflammatory drugs (NSAIDs)
Copyright 2011 André Teixeira Lima

Photo credit: Dust mites
Copyright 2011 Kennyall