Asthma Attack

What is an asthma attack?

An asthma attack describes a worsening of asthma symptoms. They can come on suddenly and take you completely by surprise or build up gradually over several hours. Asthma is a lung condition that makes your airways narrow. It causes symptoms like coughing, wheezing or shortness of breath that make it hard to breathe.

Most people with asthma can manage their symptoms with a combination of medication and habits. But sometimes, asthma symptoms flare up and worsen more than usual. This is an asthma attack.

Asthma attacks can be serious and life-threatening. If you have asthma, take precautions to avoid asthma triggers and follow your asthma treatment plan. These steps can stop an asthma attack before it begins.

How common are asthma attacks?

More than 10 million people with asthma in the United States have an asthma attack each year. That’s almost half of all people with asthma in the U.S. Asthma attacks cause about 1.6 million emergency room (ER) visits per year.

People with severe asthma tend to have more asthma attacks than people with mild asthma. But that doesn’t mean your asthma attacks will always cause severe symptoms.

What are the signs of an asthma attack?

Warning signs can vary from person to person. Symptoms of an asthma attack can include:

• Worsening of your usual asthma symptoms (such as cough, not being able to breathe and chest tightness).
• Your inhaler or bronchodilator not working as well as usual.
• Being unable to talk, eat, sleep or perform usual tasks due to asthma symptoms.
• Breathing faster or gasping for air.
• Noisy breathing when you exhale (wheezing).
• A low peak flow.

These symptoms can come on quickly or slowly over time. While many people think asthma attacks happen abruptly, this isn’t always the case. Some people can feel an asthma attack build over several hours or even several days.

What causes an asthma attack?

An asthma attack happens when an asthma trigger seriously irritates your lungs. Your lungs react by becoming swollen and inflamed. The muscles of your lungs tighten and produce extra mucus. The extra mucus, coupled with the inflammation, narrows your airways and makes it harder for air to get into your lungs.

What are common triggers for asthma attacks?

Asthma attacks typically happen due to a trigger. These triggers are sometimes within your control, but sometimes, out of your control. Some common asthma triggers include:

• Indoor allergens like dust, pet dander or mold.
• Outdoor allergens like pollen from grass or plants.
• Respiratory infections or viruses like a cold or the flu.
• Strong smells like fuel, tobacco smoke, perfume or other airborne pollutants.
• Hormonal changes.
• Strong emotional changes or feelings of stress (it can change your normal breathing pattern).
• Exercising or overexerting yourself.
• High humidity or extreme temperature changes.
• Wildfire smoke or other outdoor air pollutants.

What are the complications of an asthma attack?

Complications of an asthma attack can be severe. During a severe asthma attack, you can experience life-threatening breathing difficulties that need to be treated at the emergency room. It’s important to seek treatment for asthma so you know what to do if you have an asthma attack.

What are risk factors for an asthma attack?

Anyone with asthma can have an asthma attack. Certain factors increase your risk, including:

• Having had an asthma attack in the past.
• Using your rescue inhaler more than usual.
• Having a chronic health condition like cardiovascular disease or diabetes.
• Unmanaged environmental allergies.

How do I know if I’m having an asthma attack?

You can usually tell when your asthma symptoms are getting worse than usual. People who have asthma attacks describe it as feeling like someone is sitting on their chest or feeling like they can’t get a good breath. Only you know what’s normal for you and what’s not.

Some people have warning signs of an attack that build up. This could include needing to use their rescue medication more frequently or not being able to exercise as they normally do. For others, their symptoms come on faster without warning.

Talk to your healthcare provider about an asthma action plan. This outlines what you should do if you have an asthma attack.

How do healthcare providers diagnose an asthma attack?

Talk to your healthcare provider about your asthma symptoms and any asthma attacks you have. They’ll likely be able to confirm an asthma attack by listening to how you describe your symptoms and ordering a few tests. These tests include:

• Peak flow: A peak flow is a measurement of how fast you can blow air out of your lungs. It tells healthcare providers how open your airways are.
• Spirometry: This test measures how much air goes in and out of your lungs.
• Pulse oximetry: This test measures your blood oxygen level using a device that lightly clamps your finger.

What do I do if I’m having an asthma attack?

First, try not to panic. While it can feel scary, try to remain calm. You should also remain sitting upright, as this helps keep your airways open. Try your best to take several deep breaths by breathing in through your nose and out through your mouth.

As part of your asthma diagnosis, your healthcare provider will prescribe you a quick-acting rescue inhaler. These inhalers contain albuterol or levalbuterol, medicines that widen your airways. You may need up to six puffs of your inhaler to feel relief. You need to wait about one minute between puffs. Your provider will tell you how often you can use your rescue inhaler. The details will also be in your asthma action plan.

If you don’t feel relief from your inhaler, contact 911 (or your emergency services number) or go to the nearest ER.

Some people need oral corticosteroids after an asthma attack to reduce inflammation in their airways.

Providers in the emergency room may treat you with supplemental oxygen, BiPAP or intubation with mechanical ventilation to help you breathe.

How can I prevent an asthma attack?

These steps can help prevent asthma attacks:

• Follow your asthma action plan or asthma treatment plan.
• Take any asthma medications as prescribed. These can reduce your chances of an asthma attack or needing a rescue inhaler.
• Visit your healthcare provider as often as they suggest for checkups. Regular visits help your provider check on your asthma and make any necessary changes to your treatment.
• Try to avoid your asthma triggers. Some things are harder than others to avoid, but being aware of what triggers your asthma and taking steps to avoid them is critical to helping avoid an asthma attack.
• Pay attention to your asthma symptoms and notify your healthcare provider if your symptoms worsen.

How long do asthma attacks last?

It can vary depending on the cause and if your airways were swollen to begin with. A mild asthma attack may last a few minutes, while a serious one can last hours or days. A quick-acting inhaler usually helps a mild asthma attack. Serious attacks may require hospitalization.

Will I have asthma attacks for the rest of my life?

There’s no cure for asthma, and you’ll have to manage your symptoms for life. For this reason, you can have asthma attacks for the rest of your life, too.

A common misconception is that children outgrow asthma. Your child may have fewer asthma symptoms as they grow, making you believe their asthma went away, but they still have it. About half of children who seem to outgrow their asthma end up with symptoms again as an adult.

When should I see my healthcare provider?

Let your healthcare provider know if you have an asthma attack, especially if it’s harder to find relief after using your inhaler. It’s important to not ignore worsening asthma symptoms.

When should I go to the ER?

Go to the emergency room if you’re having an asthma attack and your symptoms don’t improve after using your rescue inhaler. Turning blue or passing out are signs you need medical attention right away.