Symptoms and causes


Asthma attack signs and symptoms 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
  • Symptoms that fail to respond to use of a quick-acting (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 emergency room care. Your doctor can help you learn to recognize an asthma emergency so that you'll know when to get help.

When to see a doctor

If your asthma flares up, immediately follow the treatment steps you and your doctor worked out ahead of time in your written asthma plan. If your symptoms and peak expiratory flow (PEF) readings improve, home treatment may be all that's needed. If your symptoms don't improve with home treatment, you may need to seek emergency care.

When your asthma symptoms flare up, follow your written asthma plan's instructions for using your quick-acting (rescue) inhaler. PEF readings ranging from 50 to 79 percent of your personal best are a sign you need to use the quick-acting (rescue) medications prescribed by your doctor.

Check asthma control steps with 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
  • No improvement after using a quick-acting (rescue) inhaler


An overly sensitive immune system makes your airways (bronchial tubes) become inflamed and swollen when you're exposed to certain triggers. Asthma triggers vary from person to person. Common asthma attack triggers include:

  • Pollen, pets, mold and dust mites
  • Upper respiratory infections
  • Tobacco smoke
  • Inhaling cold, dry air
  • Gastroesophageal reflux disease (GERD)
  • Stress

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've previously required intubation for an asthma attack
  • You use more than two quick-acting (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, or cardiovascular or chronic lung disease


Asthma attacks can be serious.

  • 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.
Oct. 20, 2016
  1. Hazeldine V. Pharmacological management of acute asthma exacerbations in adults. Nursing Standard. 2013;27:43.
  2. Fanta CH. Treatment of acute exacerbations of asthma in adults. Accessed July 19, 2016.
  3. Expert panel report 3 (EPR-3): Guidelines for the diagnosis and management of asthma. Bethesda, Md.: National Heart, Lung, and Blood Institute. Accessed June 23, 2016.
  4. Bope ET, et al. The respiratory system. In: Conn's Current Therapy 2016. Philadelphia, Pa.: Elsevier; 2016. Accessed July 24, 2016.
  5. Li JTC (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 5, 2016.
  6. Dweik RA, et al. Exhaled nitric oxide analysis and applications. Accessed July 1, 2016.
  7. Corliss J, et al. Patient information: Asthma in adults (the basics). Accessed July 1, 2016.
  8. Bailey W, et al. What do patients need to know about their asthma? Accessed July 1, 2016.
  9. Global strategy for asthma management and prevention (2015 update). Global Initiative for Asthma. Accessed July 19, 2016.
  10. Irvin CG, et al. Use of pulmonary function testing in the diagnosis of asthma. Accessed July 1, 2016.
  11. Adkinson NF, et al. Emergency treatment and approach to the patient with acute asthma. In: Middleton's Allergy: Principles and Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. Accessed July 24, 2016.
  12. Fanta CH. An overview of asthma management. Accessed July 19, 2016.
  13. What is asthma? National Heart, Lung, and Blood Institute. Accessed July 19, 2016.