Bronchospasm

A bronchospasm (pronounced “BRONG-kuh-spaz-uhm”) is when the muscles that line your bronchi tighten. Your bronchi are the tubes that air travels through to get to your lungs. They connect your windpipe (trachea) to your lungs. If the muscles in your bronchi tighten or squeeze, your airways narrow. This limits how much oxygen your body receives. Bronchospasms can occur alongside many different lung conditions, including:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Emphysema
• Lung infections
• Allergic reactions, including anaphylaxis

They can be scary because it feels like you can’t get enough air to breathe. Go to the nearest emergency room if you have sudden or severe breathing problems.

What are the symptoms of bronchospasm?

The main symptom of bronchospasm is the feeling that you can’t catch your breath. Other bronchospasm symptoms include:

• Wheezing
• Chest pain or chest tightness
• Coughing
• Shortness of breath
• Dizziness
• Fatigue

What is the cause of bronchospasm?

Asthma is the most common cause of bronchospasm. But many other things can also cause irritation and swelling in your airways. Irritation and swelling can cause bronchospasm. These include:

• Allergens, like dust, pollen and pet dander
• Bacterial, fungal or viral infections in your lungs or airways
• Chemical fumes or other irritants, like perfume or cologne
• Cold or hot/humid temperatures
• Exercise (exercise-induced bronchospasm)
• General anesthesia
• Smoking or vaping
• Poor air quality

Just because you have a condition or are around a trigger, it doesn’t mean you’ll have a bronchospasm. In rare cases, bronchospasm medications like albuterol can actually make your symptoms worse. This is a paradoxical bronchospasm. If this happens, stop using your bronchodilator immediately and tell your healthcare provider. They’ll work with you to find a different treatment.

Is it contagious?

No, bronchospasms aren’t contagious. But some bronchospasm causes are contagious, like bacterial or viral infections.

How doctors diagnose bronchospasm

A healthcare provider can diagnose bronchospasm. They’ll review your medical history, ask about your symptoms and perform a physical exam. During the exam, they may listen to your lungs with a stethoscope. If they think you’re having bronchospasms, they may refer you to a pulmonologist or allergist.

What does it sound like?

Healthcare providers listen to your lungs with a stethoscope. Stethoscopes pick up very quiet sounds. When they use one, they listen for high-pitched whistling sounds.

Tests that are used

Your healthcare provider may recommend pulmonary (lung) function tests to see how well your lungs work. These may include:

• Spirometry: You use a spirometer that measures the force of air as you breathe in and out.
• Lung diffusion capacity: You breathe into a tube to determine how well oxygen transfers or diffuses between your lungs and blood.
• Lung volume assessment: This tells your provider how much air your lungs can hold.
• Pulse oximetry: Your provider places a device on your finger or ear to measure how much oxygen is in your blood.

Depending on your history, your provider may also recommend:

• Methacholine challenge or provocation tests: These test for the presence of asthma. They measure how your lungs respond to methacholine. Methacholine is a medication that can induce bronchospasm.
• Imaging tests: Chest X-rays and CT scans can help your provider see infections or other lung problems.
• Arterial blood gas: This test measures the amount of oxygen and carbon dioxide in your blood. It also measures the levels of acids and bases (alkaline) in your blood (pH level).
• Eucapnic voluntary hyperventilation: This test checks for exercise-induced bronchospasm. You breathe in a mixture of oxygen and carbon dioxide. The mixture mimics breathing during exercise. You likely have exercise-induced bronchospasm if the mixture negatively affects your lungs.

How do you treat bronchospasm?

Bronchospasm treatment usually starts with bronchodilators. Bronchodilators are available as inhalers, nebulizer solutions and tablets. There are short-acting bronchodilators and long-acting bronchodilators.

Short-acting bronchodilators offer quick “rescue relief” for bronchospasm symptoms. They can widen your airways in a matter of minutes. The effects can last up to six hours. Common short-acting bronchodilators are albuterol and levalbuterol.

Long-acting bronchodilators reduce your risk of bronchospasms in the future. Except for formoterol, they don’t offer quick relief. But they last for up to 12 hours. Other common long-acting bronchodilators include salmeterol and vilanterol. Providers may use formoterol for rescue or quick relief instead of albuterol or levalbuterol.

Other forms of long-acting bronchodilators include anticholinergics. They’re available as short-acting inhalers (ipratropium) and long-acting inhalers (tiotropium, umeclidinium, aclidinium). They’re also available as nebulizers (glycopyrrolate, revefenacin).

Providers commonly prescribe inhaled steroids, too. Inhaled steroids help reduce inflammation in your airways and prevent bronchospasm. In cases of severe bronchospasm, go to the ER or a hospital. They may give you steroids as a pill or through a peripheral IV if they can’t manage your symptoms.

How do you treat it at home?

There aren’t any home remedies that can stop a bronchospasm once it starts. You need a short-acting bronchodilator to ease the symptoms of an attack. You likely have a bronchodilator if a provider has diagnosed you with bronchospasm. But if this is your first bronchospasm and you don’t have a bronchodilator, go to the nearest ER for treatment.

Some providers believe breathing exercises can reduce your risk of bronchospasm. But research is ongoing, and it needs more evidence. Even so, breathing exercises can’t stop a bronchospasm once it has started.

If you get bronchospasms, your provider will tell you how to best manage them.

When should I see my healthcare provider?

Get to the ER or call 911 if you have bronchospasm symptoms and don’t have a bronchodilator. Symptoms may include:

• Trouble catching your breath
• Uncontrolled coughing
• Chest pain while breathing
• Feeling dizzy
• Persistent wheezing

Contact your provider if you develop bronchospasm symptoms that linger. You should also reach out if your symptoms affect your daily activities.

What can I expect if I have bronchospasm?

If a provider diagnoses you with bronchospasm, they’ll likely prescribe a short-acting bronchodilator. You use this in case of an attack. They may also prescribe you a long-acting bronchodilator along with an inhaled steroid. This helps reduce your risk of bronchospasms in the future. Bronchodilators alone won’t prevent future bronchospasms.

How long does it last?

How long a bronchospasm episode lasts can vary. It depends on the underlying cause, severity and your response to treatment. Episodes can last minutes to days. Bronchodilators can help you manage your symptoms during this time.

Is it life-threatening?

Yes. Without treatment, severe bronchospasm can be fatal. But with quick treatment, your symptoms will usually go away within minutes. If you develop bronchospasm symptoms, use your bronchodilator as soon as possible. If you don’t have a bronchodilator and can’t breathe, call 911 or go to the ER.

Can bronchospasm be prevented?

No, you can’t prevent bronchospasm. But you can help reduce your risk by:

• Taking asthma medications as prescribed by your healthcare provider
• Avoiding or quitting smoking and vaping
• Drinking plenty of water to loosen up mucus in your chest
• Limiting your exposure to very cold or hot/humid environments
• Staying indoors when the air quality is poor
• Limiting allergen exposure
• Staying up to date on your vaccines, especially if you’re 65 or older

Your provider may also recommend that you use bronchodilators before you exercise.

What is the difference between an asthma attack and bronchospasm?

Bronchospasm is a symptom of asthma and other conditions. People with asthma can get bronchospasm. But not everyone with bronchospasm has asthma. Bronchospasm and asthma result from irritated or inflamed airways.

Are bronchitis and bronchospasm the same?

No. Bronchospasm and bronchitis are similar but not the same. Bronchitis is when inflammation causes your bronchi and windpipe to swell and fill with mucus. It may cause bronchospasm. But not everyone who has bronchitis has bronchospasm.