Asthma attack symptoms
Understand the five symptoms of an asthma attack to better get the treatment you need during an episode.

Asthma is a chronic respiratory disease characterized by episodic swelling and narrowing of the airways. While it often starts in childhood, adult-onset asthma is also possible.

Asthma attack symptoms arise due to inflammation in the airways, stress or seasonal changes. These symptoms may or may not occur suddenly. In fact, they often develop slowly over a few hours or days. Identifying when an asthma attack is about to occur can better help you manage your symptoms.

Here are five ways to identify an asthma attack:

  1. The hallmark of asthma is wheezing, which is a whistle-like noise emerging from the airways when patients exhale. Some patients, however, may not have any wheezing.
  2. Chest tightness or discomfort when breathing.
  3. Cough variant asthma may be present with dry (nonproductive) coughing that does not respond to antihistamines and worsens at night or in the early hours of the morning.
  4. Patients experience breathing issues where they feel like their breathing is getting faster, they cannot catch their breath and the skin on their chest or neck sinks or moves inward as they breathe.
  5. Nonspecific symptoms such as a pale or sweaty face during an attack, irritability and feeling low.

What are the three types of asthma?

Understanding the different types of asthma can help patients seek the most effective treatment during an asthma attack. The three most common types of asthma are:

Exercise-induced asthma or exercise-induced bronchoconstriction

  • Exercise does not directly cause asthma, but physical exertion during exercise can trigger the condition.
  • Coughing and wheezing are the most common symptoms of exercise-induced asthma.
  • With exercise-induced asthma, airway narrowings peak 5 to 20 minutes after exercise begins, making it difficult to catch a breath.
  • Symptoms begin within a few minutes of exercise and peak or worsen a few minutes after exercise ends.
  • Usually, doctors recommend a bronchodilator (an asthma inhaler) for this type of asthma.

Allergic asthma or occupational/seasonal asthma:

  • Inhaling allergens is the most common trigger for inducing allergic asthma, which includes: 
  • Sometimes, allergic asthma may be due to a patients’ occupation (paint, metal or gas); hence, patients must determine the exact trigger and consult an allergist or immunologist.
  • Few patients may develop asthma only during the winter season because the cold can trigger asthma attacks.
  • Anyone who has an allergy due to allergens, the season or their occupation may require an immunologist or allergist intervention.
  • Doctors recommend preventive and reliever inhalers for this type of asthma.

Nocturnal asthma:

  • Patients may develop nocturnal asthma along with another type of the condition, including all those mentioned above.
  • Usually, patients wake up coughing, wheezing or with chest pain; hence, more effective and long-term treatment is required for this type of asthma.
  • Studies show that most deaths related to asthma occur at night due to these potential reasons:
    • Increased exposure to allergens (asthma triggers)
    • Cooling of the airways
    • A reclining position
    • Hormone secretions
  • Sometimes, normal heartburn can trigger asthma symptoms at night.
  • Doctors may recommend diet changes, eye drops, nasal decongestants and regular saline nasal rinse to wash out allergens.

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What are the common treatment options for an asthma attack?

Long-term control and prevention are the key methods to stop asthma attacks before they start. Treatment usually involves recognizing triggers and avoiding them as much as possible.

There's currently no cure for asthma, but treatment can help control the symptoms so that patients may be able to live a normal, active life. Treatment may include:

Inhalers:

  • These may relieve symptoms when they occur (reliever inhalers) and stop symptoms from developing (preventer inhalers). Some patients need an inhaler that does both (combination inhalers).

Tablets: Patients may need to take tablets if using inhalers alone is not helping to control their symptoms.

  • Leukotriene receptor antagonists (LTRAs): LTRAs are the main tablets used for asthma. They also come in syrup and powder form.
  • Theophylline: Doctors may recommend theophylline if other treatments do not help control the patient’s symptoms.
  • Steroid tablets: Doctors may recommend steroid tablets if patients are unable to take any of the above medications to control their symptoms. They may give these tablets as an immediate treatment or every day for long-term treatment to prevent the symptoms.

Injections:

  • For some patients with severe asthma, doctors may give an injection, such as Fasenra (benralizumab), every few weeks to control their symptoms.
  • These medicines are not suitable for everyone and can only be prescribed by an asthma specialist.

Surgery: 

  • Doctors may offer a procedure called bronchial thermoplasty as a treatment for patients with severe asthma. This procedure works well, and there are no serious concerns about its safety.
  • Doctors may sedate patients using general anesthesia during bronchial thermoplasty. The procedure involves passing a thin, flexible tube down the throat and into the lungs.
  • Heat is then used on the muscles around the airways to help stop them from narrowing and causing asthma symptoms.

Breathing exercise:

  • There’s some evidence that breathing exercises can improve symptoms and reduce the need for reliever medicines in some patients, but they should not replace asthma medications.

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Medically Reviewed on 7/22/2021
References
Asthma Attack: https://acaai.org/asthma/symptoms/asthma-attack

Types of Asthma: https://www.webmd.com/asthma/types-asthma

Asthma: https://www.medicinenet.com/asthma_overview/article.htm