Asthma attack: signs and symptoms

An asthma attack feels somewhat like taking a deep breath of air on a very cold day, holding it in, and trying to take another breath. Breathing becomes difficult and can even hurt. You may cough, wheeze or make a whistling sound.

These problems happen because the airways narrow. The muscles around the airways tighten, and the inner lining of the airways swell while membranes lining the airways secrete mucus that can block air passages.

The result: a wheezing sound resulting from the rush of air through the narrowed passages. And there could be other symptoms-coughing, chest tightness, breathing difficulty or, in severe attacks, feelings of anxiety, profuse sweating, an increased pulse rate or even a bluish color in the face and lips.

Early Warning Signs

Although asthma attacks can come on suddenly, most people experience some warning signs-often as much as one day in advance. The signs can be subtle and differ from person to person. But by learning to recognize signs of an impending attack, you can take steps to head it off, or at least reduce its severity.

Changes in breathing patterns, such as an unexplained shortness of breath, or a gradual increase in coughing are two of the most common warning signs. But any of the following symptoms could indicate a coming attack and should prompt you to take appropriate measures (which depend on your doctors management medication plan):

Sudden coughing
Itchy chin or throat
Dryness in the mouth
Tightness in the chest
Breathing through the mouth, unrelated to vigorous exercise
Increased pulse rate (unrelated to exercise)
Fatigue
Complaints of not feeling well
Feelings of nervousness, anxiety or irritability
Increased sweating
In children, becoming overactive or unusually quiet.

During An Attack

During an actual asthma attack, constriction of the airways and formation of thick mucus makes it progressively more difficult to inhale and exhale. This leads to one or more of the following symptoms:

Tightness in the chest
Shortness of breath
A chronic or recurring cough
Wheezing, particularly when trying to exhale
Anxiety or agitation
Flaring of the nostrils when breathing-especially in children.

Less common symptoms during an attack include rapid heartbeat, restlessness, pallor, fatigue, vomiting or postnasal drip. In many cases, the attack may not be over when it first subsides, particularly if it developed as a result of exposure to an allergen such as animal dander, dust or even exercise. Typically, these attacks peak within 10 to 15 minutes and subside completely within one to two hours. But symptoms may return up to eight hours later, and persist for hours or even days. These return attacks are called a late asthmatic response and stem from substances released by cells in response to an allergic reaction. These substances, called mediators, communicate between cells, and attract white blood cells called eosinophils which in turn cause further inflammation and mucus secretion leading to a second, more severe asthma attack. In a sense, the second attack is caused by a physical reaction to the first one.