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Asthma attack

What is an asthma attack?

When a person's asthma symptoms such as difficulty breathing, wheezing or coughing become significantly worse, this is called an asthma attack.

Muscles around the airways tighten, called bronchospasm, and the lining of the airways becomes swollen or inflamed and there’s excess mucus.

Symptoms of an asthma attack include:

  • Severe wheezing when breathing in and out
  • Coughing with asthma that will not 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
  • Worsening symptoms despite the use of medicines.

Some people with asthma may go for extended periods without having an asthma attack or other symptoms. This can be interrupted by periodic worsening of their symptoms, due to exposure to asthma triggers or perhaps from overdoing it during exercise for exercise-induced asthma.

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

Without immediate asthma medicine and asthma treatment, breathing may become more laboured and wheezing may get louder. If a person uses a peak flow meter during an asthma attack, their personal best reading will probably be reduced.

As the lungs continue to tighten during the asthma attack, a person will probably not be able to use the peak flow meter at all. Gradually, the lungs may tighten so much during an asthma attack that there is not enough air movement to produce wheezing. This is sometimes called the "silent chest," and is a dangerous sign. Anyone affected should be taken to hospital immediately with a severe asthma attack. Unfortunately, some people interpret the disappearance of wheezing during the asthma attack as a sign of improvement and fail to get prompt emergency care.

If someone does not receive adequate treatment during an asthma attack, eventually they may become unable to speak and develop a bluish colouring around the lips. This colour change, known as "cyanosis", shows that there is not enough oxygen in the blood. At this point the person may need immediate treatment in an intensive care unit, and there is a risk of loss of consciousness and even death.

Early warning signs of an asthma attack

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 asthma attack symptoms are not severe enough to stop you from going about your daily activities. However, by recognising these signs, you can stop an asthma attack or prevent one from getting worse.

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