Asthma is a chronic lung disease that makes it hard to breathe. The problem can cause symptoms that range from mild to severe. In some severe cases, symptoms can threaten your life.

Asthma symptoms trigger swelling in the airways that carry air in and out of your lungs. This causes them to become smaller and tighter. Inflamed airways make it hard for air to flow through these tubes. When the airflow to your lungs is blocked, it is hard to breathe normally.

While there is no cure for asthma, you can control the disease with proper treatment and medication. Most people can live a normal life when they manage their asthma symptoms.

This article describes asthma symptoms and its causes, diagnosis, and treatment. It also discusses how to handle an asthma attack with and without an inhaler and how to prevent these episodes.

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Asthma Symptoms: What Does It Feel Like?

Asthma doesn’t produce the same symptoms in everyone. Some people have just one symptom, while others have more than one. Common asthma symptoms include the following:

  • Coughing
  • Wheezing (a high-pitched whistling sound produced when you breathe in and out)
  • Chest tightness that can feel like someone is sitting on your chest
  • Shortness of breath that makes it hard to walk or talk normally

In a more severe asthma attack, a person may experience:

  • Breathing that is faster or slower than normal
  • Breathing that is shallow or labored
  • An expanded chest that does not deflate with exhaling
  • Posturing (hunched over shoulders)
  • Cyanosis (blue, grayish, or purple fingertips, nail beds, and mucous membranes of the lips, tongue, and/or around your eyes) due to a lack of sufficient oxygen in your blood
  • A feeling that the air is being sucked out of you or you’re trying to breathe in through a straw
  • Light-headedness (a feeling of fainting or losing consciousness)
  • Chest retractions (the spontaneous action of your skin sinking in between or around your neck, chest plate, and/or rib bones when you inhale)
  • A feeling of panic, confusion, disorientation, and/or agitation

Asthma Symptoms in Adults vs. Kids

Children with asthma commonly have coughing, wheezing, and shortness of breath, just as in adults. The following symptoms may also be seen in pediatric asthma:

  • Coughing or difficult breathing that interferes with restful sleep
  • Constant coughing triggered by cold air, exercise, sleep, or made worse by viral respiratory infections
  • Rapid breathing or shortness of breath triggered by exercise
  • Fatigue that causes your child to slow down, stop playing, or have trouble doing normal activities
  • In infants, grunting or other problems during feeding
  • Irritability, agitation, crankiness, and/or lethargy

Symptoms during a severe asthma attack may include:

  • Labored breathing marked by exaggerated belly movement, nasal flaring, or sucking in of skin in and around and between the ribs or above the sternum (breastbone)
  • Uncontrollable rapid breathing or struggling to breathe even when sitting still
  • Inability to talk more than a few words without pausing
  • Failure to respond to or recognize parents

Asthma Attack vs. Panic Attack

Symptoms of an asthma attack and a panic attack can often feel similar because they both cause chest tightness and shortness of breath. An asthma attack is often accompanied by wheezing and coughing. It is usually triggered by an external factor like an allergen or tobacco smoke.

Symptoms of a panic attack usually include problems like nausea, dizziness, and trembling. A panic attack is triggered by stress or anxiety.

A panic attack comes on suddenly without an apparent physical trigger (there could be a mental trigger). Asthma usually comes on slowly, in a crescendo pattern, and is often triggered by a physical trigger such as a respiratory tract infection, cold air, or exercise.

Asthma Causes and Triggers

While it may be hard to define the exact cause of your asthma, the following factors are known to contribute to the onset of asthma:

  • Family history: People who have a parent with asthma are 3 to 6 times more likely to have asthma than someone without this risk factor.
  • Allergies: Having at least one parent with allergies or having certain allergic conditions like eczema (atopic dermatitis) or hay fever (allergic rhinitis) can make you more likely to have asthma.
  • Occupational exposure: Exposure to certain elements in the workplace, such as industrial or wood dust, chemical fumes and vapors, molds, and other factors, can cause asthma symptoms in some people.
  • Viral respiratory infections: A respiratory infection during infancy or childhood can cause wheezing or asthma.
  • Smoking: Smoking, having a birthing parent who smoked during pregnancy, or being exposed to secondhand smoke can damage your airways and increase your risk of asthma.
  • Obesity: Being overweight or having obesity increases your risk of asthma.
  • Air pollution: Growing up or living in an urban area increases your risk of developing asthma due to exposure to ozone, the main component of smog.

Asthma triggers can be a substance, activity, or condition that worsens your asthma, causing an asthma flare-up or attack. Knowing your asthma triggers can help you control your asthma. Triggers vary by individual, and you can have more than one.

Some of the most common asthma triggers include the following:

  • Certain medical conditions: Conditions such as a cold, flu, sinus infection, or acid reflux, can trigger asthma symptoms.
  • Foods and medicines: If you have an allergy to a food or medicine, you may trigger allergy symptoms if you encounter or consume one of these substances.
  • Smoke: Smoke from smoking cigarettes, secondhand smoke, burning leaves, sitting near fireplaces, or other sources can make breathing difficult.
  • Animals: Saliva and dander from animals with feathers or fur can cause asthma symptoms if these are allergens for you.
  • Changes in air quality: A disruption in air quality caused by sudden or extreme weather changes, an increase of pollen in the air, or air pollution can trigger asthma symptoms.
  • Mold: Mold can commonly occur in households, schools, or the workplace, where it can trigger asthma symptoms if you have contact with it.
  • Pests: Pests, including dust mites, cockroaches, mice, and rats, are common asthma allergens.
  • Exercise: Depending on your physical condition, activities ranging from walking to intense aerobic activity can trigger asthma symptoms.
  • Strong smells: The smell of perfumes, cleaning supplies, or personal care products can trigger asthma symptoms for some people.
  • Emotions: Strong emotions like anxiety or stress can trigger asthma symptoms. In children, crying or laughing can trigger an asthma attack.

While males are more likely to have asthma in childhood, the condition is more common among females in adulthood.

How is Asthma Diagnosed?

Asthma is diagnosed by a healthcare provider based on your symptoms. The following tests are most often used to determine whether you have asthma:

  • Physical exam and medical history: The healthcare provider will examine you for general signs of illness. They will take a history of your health, ask about your exposure to secondhand smoke and other pollutants, and take a family health history, especially your family history of allergies and asthma.
  • Spirometry: Spirometry is the most common type of pulmonary function test used to diagnose asthma. It measures the amount and speed of the air you exhale as you breathe into a tube. The results show how well your lungs are working.
  • Peak expiratory flow meter test: This test uses a handheld device called a peak flow meter to measure how powerfully you can blow air from your lungs.
  • Fractional exhaled nitric oxide (FeNO) test: A FeNO test uses a handheld device to measure the amount of nitric oxide you exhale. A high level of nitric oxide can mean inflamed airways.
  • Provocation tests: Provocation tests, also called bronchoprovocation challenges, involve taking spirometry readings before and after each challenge to see how your airways react. The irritants used in the challenge can include methacholine or exercise.
  • Blood test: A blood test may be used to check your immune system to measure the level of white blood cells called eosinophils and an antibody type called immunoglobulin E (IgE).

What Is Allergic Asthma?

Allergic asthma is a type of asthma triggered by a reaction to an allergen. Allergens include harmless substances like dust, mold, pet dander, and pollen that your immune system thinks are harmful.

If you are sensitive to a substance, your body reacts with symptoms that involve airway inflammation and common symptoms of other types of asthma. Allergic asthma is the most common form of asthma.

Asthma Medication and Treatment

While asthma is incurable, a combination of medication and treatment can help you control your symptoms. Asthma medication and treatment include several types of therapies. Together, they comprise an asthma action plan, which is an individualized treatment plan for asthma.

Factors such as your age, the severity of your asthma, and the way your body responds to medicines determine the elements of your asthma action plan. An asthma action plan can be adjusted as your asthma symptoms become controlled.

An asthma action plan includes the following information that is updated annually:

  • Your list of asthma symptoms and triggers
  • List of medicines used to treat your asthma and when to take them
  • Peak flow measurements or symptoms that indicate your asthma is getting worse
  • Telephone numbers for an emergency contact, your healthcare provider, and your local hospital

Quick relief or rescue medications help prevent or relieve symptoms during an asthma attack within minutes. They are usually taken at the first sign of symptoms on an as-needed basis to relax the muscles around your airways and help you breathe easier. These medicines are usually administered via an inhaler or tablets.

Common quick-relief medicines for asthma include the following:

Short-acting beta-agonists (SABAs):

Anticholinergic drugs:

Oral corticosteroids:

Asthma controller medicines include asthma control drugs taken daily for the long term to prevent asthma attacks, control swelling, and decrease mucus production. Some are taken alone, while others are combined with other drugs.

Common asthma controller medicines include the following:

Inhaled corticosteroids:

Long-acting beta-agonists (LABAs):

Leukotriene modifiers:

Add-on controller medications:

Long-acting muscarinic antagonists: Spiriva (tiotropium)

Biologics:

If you have a severe asthma attack, your healthcare provider may recommend a procedure called bronchial thermoplasty uses heat to soften the airways that constrict during an asthma attack.

What to Do During an Asthma Attack

The most important step you can take during an asthma attack is to follow your asthma action plan. However, what you do depends on whether you have an inhaler with you.

Having an inhaler or not, it’s important to remain as calm as possible while you’re having an asthma attack. Panic and anxiety can often make your symptoms worse by tightening your chest and back muscles. This can make it harder to breathe.

If you don’t have an inhaler, follow these steps during an asthma attack:

  1. Sit up straight: This opens your airway. Don’t lie down or bend over. Doing this can further constrict your airway
  2. Take long, deep breaths to slow your breathing: Breathe in through your nose and exhale through your mouth. This can help prevent hyperventilation.
  3. Remove yourself from the trigger: Move into clean air, preferably an air-conditioned environment, and continue to take slow, deep breaths.
  4. Drink a warm, caffeinated beverage, such as coffee or tea: Caffeine has similar properties to some asthma medications. The effect can help temporarily improve airway functions.  
  5. Call 911 or get immediate medical help: Get medical help as soon as possible if your breathing doesn’t improve after taking these steps.

If you have an inhaler, follow these steps during an asthma attack:

  1. Prepare your rescue inhaler: Remove the inhaler cap and shake the device 10 to 15 times. Insert the spacer if the inhaler has one. This holds the medicine in place so you can breathe it in easier.
  2. Breathe out completely: Do this before putting your mouth around the mouthpiece.
  3. Press the inhaler once to deliver a single puff: Breathe in slowly through your mouth. Press down on the inhaler slowly and keep breathing in,
  4. Hold your breath for 10 seconds: Open your mouth and release your breath slowly.
  5. Repeat the above action as directed for the prescribed number of times: Leave a minute between each application.
  6. Seek medical treatment: Call 911 or seek immediate medical treatment if your breathing does not return to normal.

Complications of Asthma

Over the long term, you may experience complications of asthma that can affect your health in different ways. Working with your healthcare provider to manage asthma and its symptoms can help reduce your risk of the following potential complications:

How to Prevent Asthma Attacks

The best way to manage asthma is to take steps to prevent asthma attacks. Follow these steps to help prevent and reduce the number of asthma attacks that you experience:

  • Know your triggers and avoid them: Prevent interactions with irritants and known allergens.
  • Avoid exposure to any type of smoking or vaping: If you smoke, take steps to quit. Don’t remain in spaces where you’re breathing secondhand smoke.
  • Control mold and dust in your home, especially in your bedroom: Use protective covers on mattresses and pillows. Wash bedding and blankets weekly. Vacuum frequently to remove dust.
  • Update your asthma action plan annually: Your asthma action plan should be assessed and revised annually to reflect changes in your health. This is especially important for children, who may need medication changes as they grow.
  • Take controller medications as directed: Continue to take controller medications as directed, even if you don’t have asthma symptoms and feel fine.
  • Always carry your rescue medications: If you are a parent of a child with asthma, ensure they have their medication with them when they are out of your care.
  • Establish and maintain a healthy body weight: Being overweight is a major risk factor for asthma.

Living With Asthma

You can live a normal life with asthma if you work to manage your condition well. Being proactive about your condition can help you reduce your risk of asthma attacks and avoid hospital visits. This means doing your best to control your exposure to triggers in every environment and circumstance.

In the Workplace

About 21.5% of working adults with asthma report that exposures at work make their asthma worse. Control your asthma in the workplace with these steps:

  • Identify allergens and irritants: You don’t have to work in an industrial workplace to be exposed to irritants. Working in an office building can threaten your lung health with improper ventilation.
  • Use proper protective gear when working with harmful products: Learn how to wear gear properly and when to use it. Working near machines that release mists, dust, or other air pollutants can affect air quality and trigger an asthma attack.
  • Report respiratory symptoms to your employer immediately: Your employer is legally responsible for providing all employees with a safe and healthy work environment. If your employer is unresponsive, consider informing the state or local health department or the Occupational Safety and Health Administration (OSHA).

At School

Asthma is a leading cause of illness-related reasons that children miss school days. Take these steps to help your child remain in school safely:

  • Schedule an asthma visit with your healthcare provider before every school year: Review your child’s asthma care plan for necessary updates and medication adjustments. Request prescriptions for inhalers to keep at home and school.
  • Inform everyone who cares for your child about their asthma condition: Be vigilant about informing teachers, family, and friends about your child’s asthma diagnosis, their asthma action plan, and when emergency care is needed.
  • Educate your child about their condition and when to seek help: Help your child learn when to ask for help and what they can do for themselves in case of an asthma attack based on their age and abilities.
  • Teach your child how to self-administer their quick-relief medication: When they are ready, ensure your child masters this skill by working with your healthcare provider to demonstrate the proper technique. Follow up with constant practice so they can act fast if needed.
  • Talk to your child about smoking and vaping: These actions threaten the health of any child but can be especially dangerous for children with asthma.

At Play

Asthma shouldn’t interfere with your ability to play at any age. Regular exercise or participation in sports-related activities supports lung health and overall well-being. Take these steps to ensure asthma doesn’t interfere with your ability to be physically active:

  • Take prescribed medications as directed before exercise: If you have exercise-related asthma, you may have to take medication to prevent an asthma attack before you begin your activity.
  • Cover your nose and mouth with a scarf when outside in cold temperatures: Cold weather can trigger asthma attacks in some people. The scarf will help warm the air you breathe.
  • Include time to warm up and cool down with any activity: Give your body a chance to increase and decrease your activity level gradually.
  • Limit outdoor physical activities when air quality is at orange or unhealthy levels: Avoid exercising outdoors when air quality is identified at red, purple, or maroon levels.
  • Stop exercising at the first sign of pain or other asthma symptoms: If symptoms arise, sit down and take your quick-relief medication. Seek emergency care if symptoms don’t improve.

Outlook for Asthma

Asthma is a chronic, incurable disease. It requires ongoing medical management throughout your lifetime. However, symptoms can usually be controlled with treatment. With proper care and symptom management, you can participate in sports and live a normal, productive life with asthma.

While it can go into long periods of remission, the disease remains, and symptoms can resume anytime. About 50% of children with asthma outgrow the condition during adolescence, though symptoms may recur later in life.

Summary

Asthma is a chronic disease that causes swelling in the airways that carry air in and out of the lungs. When an asthma attack occurs, it becomes hard to breathe. Without proper care, severe symptoms can threaten your life.

While some children with asthma may outgrow the disease in their teens, the problem remains a lifelong issue for most adults who have it. Controlling asthma requires working with a healthcare provider to set up an asthma action plan to manage the onset of symptoms.

Reducing your risk of asthma symptoms requires knowing triggers and working to avoid them at home and in other places like work and school. Doing so can allow you to live a normal life with asthma.

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