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Asthma attack causes, symptoms, treatment and more

Asthma attack
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An asthma attack is a sudden worsening of asthma symptoms. During an attack, the muscles around the airways tighten (bronchospasm), the airway lining swells, and extra mucus narrows the airways further.

To understand an attack, it helps to understand asthma. Asthma is a long-term lung condition in which the airways are inflamed and sensitive. Airway tightening, swelling, and mucus together make breathing harder during an attack.

When a trigger enters the body of someone with allergic asthma, the immune system reacts. Immune cells, including helper T cells, release chemical signals such as IL-4, IL-5, and IL-13 that drive airway inflammation, twitchiness, and narrowing.

Symptoms can flare at certain times of year, for example during pollen season or when colds and flu are common in winter.

MILD/SEVERE ASTHMA ATTACK

Asthma attacks can be mild or severe. Mild attacks are more common and usually shorter. The airways often open up within minutes to a few hours after using a quick-relief inhaler.

Severe attacks are less common but can last longer and need immediate medical care. They can be life-threatening. Recognizing and treating early symptoms, with your doctor’s help, can prevent more severe episodes.

WHAT ARE THE CAUSATIVE AGENTS RESPONSIBLE FOR ASTHMA ATTACK?

In people with asthma, the airways become inflamed, swollen, and tight when exposed to certain triggers. Severity varies from person to person. Asthma may be allergic or non-allergic.

Allergic Asthma

Allergic asthma can be triggered by dust mites, pollen, pet dander, mold, and cockroach droppings. Irritants such as tobacco smoke, air pollution, fumes, and cold air can also set off symptoms.

Non-allergic Asthma

Non-allergic asthma can be triggered by stress or strong emotions, respiratory infections such as colds and flu, exercise, cold air, gastroesophageal reflux disease (GERD), and some medicines, such as aspirin and other NSAIDs in sensitive people.

ASTHMA ATTACK SIGNS & SYMPTOMS

Asthma attack signs and symptoms include:

  • Shortness of breath
  • Chest tightness or chest pain
  • Coughing that won’t stop
  • Wheezing when breathing in or out
  • Rapid breathing
  • Low peak expiratory flow (PEF), if you use a peak flow meter
  • Anxiety or a feeling of panic
  • Trouble speaking in full sentences
  • Rapid heart rate
  • Sweating during the attack
  • Drowsiness or confusion (a danger sign)
  • Bluish lips or face (a danger sign)

Symptoms that keep getting worse even after you use your quick-relief medicine are a warning sign.

WHEN ASTHMA ATTACK NEEDS EMERGENCY MEDICAL TREATMENT

People with asthma can keep it under control by taking their medicines as prescribed and avoiding their triggers. If your asthma isn’t controlled despite your medicine, you are more likely to have an attack, so see your health care provider.

Call 911 or get emergency care right away if you have signs of a serious attack, such as:

  • Severe shortness of breath or extreme difficulty breathing
  • Severe wheezing
  • A peak flow reading below 50% of your personal best
  • Being unable to speak more than short phrases
  • No improvement after using your quick-relief inhaler
  • Bluish lips or face
  • Drowsiness or confusion
  • A rapid pulse

These symptoms mean you need emergency medical care.

RISK FACTORS

Anyone with asthma can have an asthma attack. Keeping your asthma under control helps prevent serious complications. Factors that put you at higher risk of a serious attack include:

  • You have had a severe asthma attack before
  • You have been hospitalized or gone to the emergency room for asthma
  • You use more than one canister of quick-relief inhaler a month
  • You don’t use your controller (long-term) medicine as prescribed
  • You have other conditions, such as chronic sinusitis, nasal polyps, or another lung disease
  • Your asthma symptoms are not well controlled despite treatment

COMPLICATIONS OF UNTREATED ASTHMA ATTACK

Asthma attacks can be serious if they are ignored or left untreated. They can interrupt school, work, sleep, and exercise, and lead to emergency room visits or hospital stays that are stressful for you and your family.

In the worst cases, a severe attack can lead to respiratory arrest, cardiac arrest, or death. Following your asthma action plan and taking your medicines as prescribed helps prevent these outcomes.

ASTHMA ACTION PLANS

Everyone with asthma should create a written asthma action plan with their doctor. It helps you recognize when your asthma is getting worse and know what to do. It also helps family, friends, and caregivers know how to help during an attack.

Asthma action plans include:

  • Your daily medicines and how to take them
  • Your triggers and how to avoid them
  • How to tell when your asthma is getting worse, including peak flow zones
  • When and how much to increase your quick-relief and controller medicines
  • When to call your doctor or 911

Schools, child care providers, and employers often keep a copy of a person’s action plan in case of an emergency.

TREATMENT PLAN

Treatment varies from person to person. The first step is to use your quick-relief (reliever) inhaler as soon as symptoms start and follow your action plan for how many puffs to take and when to repeat them.

A nebulizer is often used for young children or people who have trouble using an inhaler. It turns the medicine into a fine mist that is breathed deep into the lungs.

Quick-relief medicines are usually short-acting beta2-agonists (SABAs), such as albuterol. Long-term control medicines include inhaled corticosteroids, often combined with long-acting beta2-agonists (LABAs). Severe attacks may also be treated with oral corticosteroids.

Note that these medicines are beta-agonists, not beta-blockers. Beta-blockers are heart and blood pressure medicines, and some can trigger asthma symptoms, so tell your doctor you have asthma before starting any new medicine.

PREVENTION

If you have asthma, learn your triggers and avoid them as much as you can. These steps can also help prevent attacks:

  1. Avoid tobacco smoke and limit time outdoors when air pollution is high.
  2. Lower your risk of colds and flu by washing your hands often.
  3. Reduce allergens at home, such as dust mites, mold, and pet dander.
  4. Stay up to date on vaccines, including the yearly flu shot.
  5. Ask your doctor whether immunotherapy allergy shots could help you
  6. Take your asthma medicines as prescribed, even when you feel well.

HP Thoughts: Did you know that smoke and fumes can trigger asthma? Learn how to cope with fumes in our post: How Paint Fumes Affect Your Health.

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