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Asthma Symptoms
by Michael W. Smith, MD
September 11, 2007

People with asthma experience symptoms when the airways tighten, inflame, or fill with mucus. Common symptoms of asthma include:

  • Coughing, especially at night
  • Wheezing
  • Shortness of breath
  • Chest tightness, pain, or pressure
Still, not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your asthma symptoms may also vary from one asthma attack to the next, being mild during one asthma attack and severe during another.

Some people with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks, while others have some symptoms every day. In addition, some people with asthma may only have symptoms during exercise or when they are exposed to allergy-causing substances or viral infections like colds.

Mild asthma attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild symptoms to help you prevent severe episodes and keep asthma under better control.

1. Know the Early Asthma Symptoms
Early warning signs are changes that happen just before or at the very beginning of an asthma attack. These changes start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening.

In general, these signs are not severe enough to stop you from going about your daily activities. But by recognizing these signs, you can stop an asthma attack or prevent one from getting worse. Early warning signs include:

  • Frequent cough, especially at night
  • Losing your breath easily or shortness of breath
  • Feeling very tired or weak when exercising
  • Wheezing or coughing after exercise
  • Feeling tired, easily upset, grouchy, or moody
  • Decreases or changes in lung function as measured on a peak flow meter
  • Signs of a cold, or allergies (sneezing, runny nose, cough, nasal congestion, sore throat, and headache)
  • Trouble sleeping
If you have early warning signs or symptoms, you should take more asthma medication as described in your Asthma Action Plan.

2. Know the Asthma Symptoms in Children
Asthma affects as many as 10% to 12% of children in the United States and is the leading cause of chronic illness in children. For unknown reasons, the incidence of asthma symptoms in children is steadily increasing. While asthma symptoms can begin at any age, most children have their first asthma symptoms by age 5.

Asthma is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes. Not all children with asthma wheeze. Chronic cough may be the only obvious sign, and a child’s asthma may go unrecognized if the cough is attributed to recurrent bronchitis.

For more detail, see WebMD’s article Asthma Symptoms in Children.

3. Know the Symptoms of an Asthma Attack
An asthma attack is the episode in which bands of muscle surrounding the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed and the cells lining the airways produce more and thicker mucus than normal.

All of these factors -- bronchospasm, inflammation, and mucus production -- cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack include:

  • Severe wheezing when breathing both in and out
  • Coughing that won't stop
  • Very rapid breathing
  • Chest pain or pressure
  • Tightened neck and chest muscles, called retractions
  • Difficulty talking
  • Feelings of anxiety or panic
  • Pale, sweaty face
  • Blue lips or fingernails
The severity of an asthma attack can escalate rapidly, so it's important to treat these symptoms immediately once you recognize them.

Without immediate treatment, your breathing will become more labored. If you use a peak flow meter at this time, the reading will probably be <50%.

As your lungs continue to tighten, you will be unable to use the peak flow meter at all. Gradually, your lungs will tighten so there is not enough air movement to produce wheezing. This is sometimes called the "silent chest," and it is an ominous sign. You need to be transported to a hospital immediately. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.

If you do not receive adequate treatment, you will eventually be unable to speak and will develop a bluish coloring around your lips. This color change, known as cyanosis, means you have less and less oxygen in your blood. Without aggressive treatment in an intensive care unit, you will lose consciousness and eventually die.

If you are experiencing an asthma attack, follow the "Red Zone" or emergency instructions in your Asthma Action Plan immediately. These symptoms occur in life-threatening asthma attacks. You may need medical attention right away.

For more detail, see WebMD’s article Asthma Attack Symptoms.

4. Know About Unusual Asthma Symptoms
Not everyone with asthma has the usual symptoms of cough, wheezing, and shortness of breath. Sometimes individuals have unusual asthma symptoms that may not appear to be related to asthma. Some "unusual" asthma symptoms may include the following:

  • rapid breathing
  • sighing
  • fatigue
  • inability to exercise properly
  • difficulty sleeping
  • anxiety
  • difficulty concentrating
  • chronic cough without wheezing
Also, asthma symptoms can be mimicked by other conditions such as bronchitis, vocal cord dysfunction, and even heart failure.

Understand your body. Talk with your doctor and others with asthma. Be aware that asthma may not always have the same symptoms in every person.

For more detail, see WebMD’s article Unusual Asthma Symptoms.

5. Know Why Infections Trigger Asthma Symptoms
Sometimes a virus or bacterial infection triggers asthma. For instance, you might have a cold virus that triggers your asthma symptoms. Or your asthma can be triggered by a bacterial sinus infection.

It’s important to know the signs and symptoms of respiratory tract infections and to call your doctor immediately for a diagnosis and treatment. For instance, you might have symptoms of increased shortness of breath, difficulty breathing, or wheezing with a bronchial infection. In people who don’t have asthma, the bronchial infection may not trigger the same debilitating symptoms. Know your body and understand warning signs that an infection might be starting. Then take the proper medication as prescribed to get rid of the infection and regain control of your asthma and good health.

For more detail, see WebMD’s article Infections and Asthma.

SOURCES: American Academy of Allergy Asthma & Immunology: “An Unwelcome Return: 10 tips to ease your spring allergy symptoms,” “Tips to Remember: Childhood Asthma.”
 

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