During an asthma attack, also called an asthma exacerbation, the airways become swollen and inflamed. The muscles around the airways contract and the airways produce extra mucus, causing the breathing (bronchial) tubes to narrow.
During an attack, you may cough, wheeze and have trouble breathing. Symptoms of a minor asthma attack get better with prompt home treatment. 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. Your treatment plan should include what to do when your asthma starts getting worse, and how to deal with an asthma attack in progress.
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 don't improve or get worse after you take medication as your doctor directed, you may need emergency treatment. 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 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 51% to 79% 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, you're more likely to have an asthma attack. 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, or if you have 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)
For many people, asthma symptoms get worse with respiratory infections, such as those caused by the common cold. Some people have asthma flare-ups caused by something in their work environment. Sometimes, there isn't an apparent cause for an asthma attack.
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. They 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.
- Send you to the emergency room, which can be stressful and costly.
- Lead to respiratory arrest and death.
The best way to avoid an asthma attack is to make sure your asthma is well controlled in the first place. This means following a written asthma plan to track symptoms and adjust your medication.
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-acting inhaler.
See your doctor if you're following your asthma action plan but still have frequent or bothersome symptoms or low peak flow readings. These are signs 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 wear a face mask when exercising in cold weather.