An asthma attack can cause wheezing, coughing, difficulty breathing, and tightness in the chest. People may be able to treat mild asthma attacks with asthma medication, such as an inhaler. However, anyone experiencing severe symptoms of an asthma attack will need medical help straight away.

An asthma attack happens when muscles around the airways contract, which narrows the airways. This causes symptoms such as shortness of breath, tightness in the chest, wheezing, and general difficulty breathing.

Certain triggers, such as allergens, irritants in the air, or smoke, may cause an asthma attack.

People may also refer to an asthma attack as an asthma exacerbation or asthma episode.

In this article, we explain how to recognize the signs of an asthma attack, what to do during an asthma attack, and when to seek medical help.

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The symptoms of an asthma attack can vary, depending on the severity of the attack. A mild asthma attack may last a few minutes, while a severe asthma attack may last for hours or even days.

The warning signs of a forthcoming asthma attack can include:

  • an increased need to use rescue asthma medication, particularly albuterol
  • a worsening cough
  • feeling short of breath, especially if it is causing the person to wake up from sleep
  • reduced tolerance for exercise

Signs that someone is already experiencing an asthma attack can include:

  • wheezing
  • rattling sound in the chest
  • tightness in the chest, or the feeling that someone is sitting on the chest
  • quickening breathing
  • difficulty catching a full breath
  • coughing
  • difficulty speaking

Signs of a severe asthma attack can include:

  • rapid breathing, causing the skin to “suck in” around the chest or between the ribcage when inhaling
  • changes in skin color around the eyes, lips, fingertips, or nail beds, which may appear gray or white on dark skin and bluish or purple on light skin
  • rapid movement of the nostrils
  • deep and rapid in-and-out movement of the ribs or stomach
  • expanded chest, which does not deflate on breathing out
  • in infants with asthma, no response to or recognition of their parents or caregivers

If someone is having a mild asthma attack, they may be able to treat it with asthma medication, such as a quick-acting inhaler. Some mild asthma attacks may even resolve on their own.

It is important that people with asthma talk with their healthcare team about an asthma action plan. This is a plan that guides people through how to treat their asthma, depending on the symptoms they are experiencing, and what to do in case of an asthma attack.

A person will need to carry a reliever inhaler with them, which may contain asthma medication to relax the muscles around the airways. These medications include short-acting, rapid onset beta-2 agonist and anticholinergic bronchodilators.

A person can first try dealing with an asthma attack by:

  • staying calm
  • sitting upright
  • using quick-relief medications, usually through a blue inhaler, and following their asthma action plan
  • calling 911 if the symptoms worsen or do not improve with medication

In the case of a severe asthma attack, it is essential to seek medical help or call 911 immediately. While waiting for help, a person should continue to take their inhaler medication as the manufacturer outlines.

After an asthma attack, regardless of whether medical help was necessary, the following steps are important:

  • booking a follow-up appointment with a doctor straight away, as they will need to carry out a health check and review the person’s medication and asthma action plan
  • continuing to take any asthma medication exactly as prescribed
  • taking the rest of the day to rest and recover, as an asthma attack can be physically and emotionally exhausting for many people

According to the American Lung Association, people will need to see their doctor at least once a year if they have asthma and more frequently if they have symptoms.

A person should contact their doctor straight away if they:

  • feel dizzy, faint, or weak
  • struggle to carry out an everyday task, such as cooking, cleaning, or taking out the trash
  • have a persistent cough
  • are wheezing when breathing in or out or notice changes in their normal breathing pattern
  • have wheezing that worsens after asthma medication has had time to work — usually about 15 minutes for quick relief medication

Anyone who experiences any of the following needs emergency medical help:

  • the lips or nails turning bluish, greyish, or whiteish
  • the nostrils flaring when breathing in
  • the skin stretching between the ribs or at the base of the throat when breathing in
  • breathing rate reaching 30 or more breaths per minute
  • difficulty in talking or walking at the usual pace

Keeping asthma under good control can help prevent most cases of severe asthma attacks.

Seeing a healthcare professional as soon as possible after having an asthma attack, taking any asthma medication as a doctor prescribes, and resting afterward to recover fully can all help prevent further asthma attacks.

Mild asthma attacks may resolve on their own or with the use of a quick relief inhaler. Prompt treatment can help prevent an asthma attack from becoming an emergency and help shorten and stop the attack.

Some people with asthma may benefit from using a peak flow meter, which is a breathing device that monitors how well the lungs are working. The information that the meter provides can help a doctor know when and how to adjust the person’s medication.

An asthma attack happens when muscles around the airways contract, making it more difficult to breathe. People may have symptoms such as wheezing, coughing, tightness in the chest, and changes to their breathing patterns.

It is often possible to treat a mild asthma attack with medication, such as a quick-acting inhaler.

Anyone who has a severe asthma attack will need immediate medical attention so that they can receive treatment as soon as possible.