What Are the Symptoms of Severe Asthma?

Medically Reviewed by Jennifer Robinson, MD on December 13, 2019

If you have a severe asthma attack and your regular asthma medicine doesn’t stop it, it’s an emergency. You may have symptoms such as:

  • Shortness of breath
  • Can’t speak in full sentences
  • Feel breathless even when you lie down
  • Chest feels tight
  • Bluish tint to your lips
  • Feel agitated, confused, or can’t concentrate
  • Hunched shoulders, strained abdominal and neck muscles
  • Feel that you need to sit or stand up to breathe more easily

Other things can cause some of these problems. But if you have asthma, you need to start treatment right away when these symptoms start.

Your asthma action plan, which you made with your doctor, will tell you what to do to manage your condition and when you need to call your doctor or go to the emergency room.

What About Wheezing or Coughing?

These could happen during a severe asthma attack. But you might be surprised to learn that they may not be worse than usual. Very severe asthma attacks may affect your airways so much that you don’t get enough air in and out of your lungs to make a wheezing sound or cough.

So don’t judge how bad your asthma attack is based on how much you wheeze or cough.

What to Do

If you use your quick-acting asthma medicine and it doesn’t help, call 911. Don’t drive yourself to the emergency room.

If you have a steroid medicine at home (such as prednisone), you can take it on your way to the ER.

It’s important to manage your asthma as your doctor recommends -- taking your medicines and avoiding your triggers. This may help prevent severe asthma attacks.

WebMD Medical Reference



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American Family Physician, 2003.

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National Heart, Lung and Blood Institute: "Expert Panel report 2: guidelines for the diagnosis and management of asthma."

National Institutes of Health, National Heart, Lung, and Blood Institute: "NIH publication no. 97-4051."

Circulation: "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 8: advanced challenges in resuscitation: section 3: special challenges in ECC. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation."

UptoDate: “Patient Education: Asthma treatment in adolescents and adults (Beyond the Basics).”

National Heart, Lung and Blood Institute: “What Are the Signs and Symptoms of Asthma?”

CDC: "Asthma Action Plan.”

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