Overview
During an asthma attack, also called an asthma exacerbation, your airways become swollen and inflamed. The muscles around the airways contract, causing your breathing (bronchial) tubes to narrow.
Coughing, wheezing and having trouble in breathing are the basic signs. An asthma attack may be minor, with symptoms that get better with prompt home treatment, or it may be more serious. A severe asthma attack that doesn't improve with home treatment can become a life-threatening emergency.
The key to stopping an asthma attack is recognizing and treating an asthma flare-up early. Follow the treatment plan you worked out with your doctor ahead of time. This plan should include what to do when your asthma starts getting worse, and how to deal with an asthma attack in progress.
Symptoms
The main symptoms of a asthma include:
- Severe shortness of breath, chest tightness or pain, and coughing or wheezing.
- Low peak expiratory flow (PEF) readings, if you use a peak flow meter.
- Worsening symptoms despite use of a quick-relief (rescue) inhaler.
Signs and symptoms of an asthma attack vary from person to person. Work with your doctor to identify your particular signs and symptoms of worsening asthma — and what to do when they occur.
If your asthma symptoms keep getting worse even after you take medication as your doctor directed, you may need a trip to the emergency room. Your doctor can help you learn to recognize an asthma emergency so that you'll know when to get help.
Possible Cause
An overly sensitive immune system makes your airways (bronchial tubes) become inflamed and swollen when you're exposed to certain triggers. Common asthma attack triggers include:
- Pollen, pets, mold and dust mites.
- Upper respiratory infections.
- Tobacco smoke.
- Exercise
- Inhaling cold, dry air.
- Gastroesophageal reflux disease (GERD).
For many people, asthma symptoms get worse with a respiratory infection such as a cold. Some people have asthma flare-ups caused by something in their work environment. Sometimes, asthma attacks occur with no apparent cause.
Risk Factors
Anyone who has asthma is at risk of an asthma attack. You may be at increased risk of a serious asthma attack if:
- You've had a severe asthma attack in the past.
- You've previously been admitted to the hospital or had to go to the emergency room for asthma.
- You use more than two quick-relief (rescue) inhalers a month.
- Your asthma attacks tend to "sneak up" on you before you notice symptoms have worsened.
- You have other chronic health conditions, such as sinusitis or nasal polyps.
Complications
- Asthma attacks can interrupt everyday activities such as sleep, school, work and exercise, causing a significant impact on your quality of life — and can disrupt the lives of those around you.
- Serious asthma attacks mean you're likely to need trips to the emergency room, which can be stressful and costly.
- A very severe asthma attack can lead to respiratory arrest and death.
Care and Treatment
The best way to avoid an asthma attack is to make sure your asthma is well controlled in the first place. While you may not be able to eliminate your risk of an asthma attack, you're less likely to have one if your current treatment keeps your asthma under control. Take your inhaled medications as prescribed in your written asthma plan.
These preventive medications treat the airway inflammation that causes asthma signs and symptoms. Taken on a daily basis, these medications can reduce or eliminate asthma flare-ups — and your need to use a quick-relief inhaler.
See your doctor if you're following your asthma action plan but you still have frequent or bothersome symptoms or low peak flow readings. This is a sign that your asthma isn't well controlled, and you need to work with your doctor to change your treatment.
If your asthma symptoms flare up when you have a cold or the flu, take steps to avoid an asthma attack by watching your lung function and symptoms and adjusting your treatment as needed. Be sure to reduce exposure to your allergy triggers. And when exercising in cold weather, wear a face mask.
When to Call the Doctor
When your asthma symptoms flare up, follow your written asthma plan's instructions for using your quick-acting (rescue) inhaler. If you use a peak flow meter to monitor your asthma, PEF readings ranging from 50 to 79 is a sign that indicate you need to use quick-acting (rescue) medications prescribed by your doctor.
Asthma can change over time, so you'll need periodic adjustments to your treatment plan to keep daily symptoms under control. If your asthma isn't well controlled, it increases your risk of future asthma attacks. Lingering lung inflammation means your asthma could flare up at any time.
Go to all scheduled doctor's appointments. If you have regular asthma flare-ups, low peak flow readings or other signs your asthma isn't well controlled, make an appointment to see your doctor.
When to seek emergency medical treatment. Seek medical attention right away if you have signs or symptoms of a serious asthma attack, which include:
- Severe breathlessness or wheezing, especially at night or in the early morning.
- The inability to speak more than short phrases due to shortness of breath.
- Having to strain your chest muscles to breathe.
- Low peak flow readings when you use a peak flow meter.