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Asthma Attack Symptoms and Warning Signs

Medically Reviewed by Nayana Ambardekar, MD on May 08, 2021

You may go for weeks or months without having a flare. But suddenly, your chest feels tight. You're coughing and wheezing a bit.

During an asthma attack, the muscles in your airway tighten. The lining gets swollen and makes more and thicker mucus. All of this makes it hard to breathe.

Early Warning Signs

Just before or at the very start of an attack, you may notice changes that can tip you off. They include:

  • Coughing a lot, especially at night
  • Trouble sleeping
  • Losing your breath
  • Hard to breathe after exercise
  • Feeling cranky
  • Lower PEF numbers, from your peak flow meter

Follow the steps in your asthma action plan. You may be able to stop the episode or keep it from getting bad.

During an Attack

When symptoms flare, it might be hard for you to do normal, everyday things. You may have:

  • Short, shallow, fast breaths
  • A whistling sound when you breathe, especially out
  • A cough that won't go away
  • Squeezed feeling in your chest

Use your rescue inhaler. Try to stay calm.

When It Gets Worse

Signs of worsening asthma include:

  • Feeling panicky
  • Wheezing when you breathe both in and out
  • Inability to stop coughing
  • Having trouble talking or walking
  • Getting a tight neck and chest muscles
  • Having a pale, sweaty face

Follow the "Red Zone" or emergency instructions in your asthma action plan. Call 911 or get to the hospital. You need medical attention right away.

Warning Signs of an Asthma Emergency

Some warning signs of asthma are more serious. They include:

  • Symptoms that keep getting worse, even with treatment
  • Difficulty catching your breath or talking
  • Sucking in your chest or stomach with each breath
  • Trouble walking
  • A bluish or grayish tinge to your lips or fingernails
  • Flaring your nostrils as you breathe (more common in infants and young children)

If you have any of these asthma symptoms, call 911.

Anaphylaxis

Some people's asthma is triggered by allergies. For example, hay fever is a risk factor for developing asthma. It is important to manage your asthmas because some triggers can make it worse, and in some cases a serious type of allergic reaction called anaphylaxis can occur. Anaphylaxis can be caused by food allergies, latex allergies, medication allergies, or allergies to insect stings.

Most allergic reactions are localized to one area of your body. An allergic reaction in your skin leads to hives. An allergic reaction in your nose leads to congestion. But in anaphylaxis, many organs of your body are affected at once. The results are rapid and life-threatening.

Some of the symptoms of a severe asthma attack or a severe allergic reaction may seem similar. Signs of anaphylaxis are:

  • Hives and itchiness
  • Vomiting
  • Diarrhea
  • Pain in the abdomen
  • Severe swelling in the throat that makes it hard to swallow or breathe; this can lead to stridor, or wheezing.
  • Confusion
  • Slurred speech
  • Fast or weak pulse
  • Dizziness (caused by a drop in blood pressure)
  • Unconsciousness

Anaphylaxis is a medical emergency. Keep in mind that anaphylaxis often develops quickly after exposure to the allergen -- possibly within minutes. If you know you’re at risk for anaphylaxis, your doctor should have prescribed an epinephrine injection kit for emergencies (usually two pens). Always carry it with you and do not hesitate to use it to inject yourself, even if you are unsure that your symptoms are allergy related.

After an Asthma Attack

You'll probably feel tired and worn out. For the next few days, you're more likely to have another flare too. Pay attention to warning signs. Take care of yourself.

  • Follow your asthma action plan closely. Make sure you take your medications.
  • Use your peak flow meter.
  • Avoid your triggers.
WebMD Medical Reference

Sources

SOURCES:

UptoDate Patient Information: "Trigger avoidance in asthma," "Pathogenesis and management of status asthmaticus in adults."

American Academy of Allergy, Asthma & Immunology: "Tips to Remember: asthma triggers and management," "Allergic Conditions: Exercise-Induced Asthma (EIA)."

Merck Manual Home Edition: "Asthma."

getasthmahelp.org.

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