Can a person have asthma without wheezing?

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A person can have asthma without wheezing. However, wheezing is a common symptom of the disease.

During an asthma attack, the muscles around the airways, or bronchial tubes, tighten, while the inside of the airways become inflamed and swollen. Mucus can also block the narrow tubes. The blocked airways make it difficult for a person to breathe.

When this happens, a person can experience various symptoms, including wheezing. Wheezing is a squeaking or whistling sound that the airway produces when it is inflamed or blocked.

Not everyone experiences wheezing with asthma.

This is especially true of people with cough-variant asthma or silent asthma symptoms.

Cough-variant asthma

In cough-variant asthma, the only symptom of the disease is a cough.

A person with this type of asthma typically does not have other common asthma symptoms, such as wheezing. This type of asthma is common in children.

Cough-variant asthma may cause:

• An acute cough: This type of cough lasts less than 3 weeks.
• A chronic cough: Chronic coughs last for longer than 8 weeks.
• An intractable cough: This is a cough that is difficult to treat and does not respond well to usual treatment methods.

For some people, cough-variant asthma is a precursor to classic asthma, although not always.

Certain triggers can trigger bouts of coughing in people with this form of asthma. These include:

• exercise
• dry, cold weather
• certain food additives
• certain medications
• stress
• exposure to allergens, such as pollen or pet dander
• environmental irritants, such as smoke or chemical fumes
• illnesses, such as colds or flu

Cough-variant asthma does not typically respond to the usual cough treatments, such as over-the-counter cough medication.

Instead, doctors may prescribe asthma medication, such as bronchodilators and corticosteroid inhalers.

Silent asthma

Silent asthma refers to asthma that does not cause wheezing and coughing. It may also refer to a silent chest, a life threatening situation where air cannot enter or leave the lungs.

Silent asthma symptoms can include shortness of breath, which doctors sometimes refer to as dyspnea.

Dyspnea can make people feel like they are not getting enough air or something is smothering them.

Another silent asthma symptom is tightness in the chest. As the airways narrow, a person may feel like a band is tightening around their chest.

Someone with life threatening asthma — a type of asthma that does not respond to usual treatment methods — may experience chest silence during an asthma attack.

A silent chest indicates no air is entering or leaving the lungs. A person may also experience systemic hypoxia, which means their cells and tissues are not receiving enough oxygen to function properly.

In addition to wheezing, asthma symptoms include:

• shortness of breath
• chest tightness
• higher mucus production
• coughing
• waking during the night

Someone with life threatening asthma may also experience:

• silent chest
• exhaustion
• confusion
• low blood pressure
• irregular heartbeats
• slow heartbeat
• cyanosis, when the skin is blue- or gray-tinged from a lack of oxygen

If a person does not have an asthma diagnosis and experiences symptoms, such as shortness of breath, a chronic cough, or tightness in the chest, they should consider contacting a doctor.

Individuals should contact emergency medical services if they experience symptoms of a severe asthma attack. These include:

• asthma not responding to quick-relief medications
• asthma rapidly worsening
• rapid in and out movement in the ribs and stomach
• faster or slower than usual breathing
• hard or shallow breathing
• severe shortness of breath
• pain or tightness in the chest
• difficulty talking or walking due to shortness of breath
• chest not deflating upon exhaling
• hunched shoulder posture
• cyanosis
• confusion
• drowsiness
• fainting
• respiratory retractions, in which the skin around the neck, chest, or ribs appears to suck inward

Symptoms of a severe asthma attack may present differently in infants and children. They may include:

• nostrils flaring
• failure to respond to or recognize caregivers
• exaggerated belly and rib movements
• respiratory retractions
• lethargy
• appearing floppy or bobbing their head
• seeming agitated or irritable
• cyanosis

Below are answers to common questions about asthma and asthma without wheezing.

Is silent asthma dangerous?

In some cases, silent asthma can indicate a life threatening asthma attack. Doctors call this a silent chest, meaning air cannot enter or leave the lungs.

Additionally, someone with classic asthma may experience silent symptoms, such as shortness of breath and chest tightness, and may not experience wheezing or coughing.

What else can cause asthma-like symptoms?

Various conditions can cause symptoms similar to asthma. These include:

• gastrointestinal reflux disease
• allergies
• sinus infection
• heart attack
• chronic obstructive pulmonary disease
• lung cancer
• pneumonia
• bronchiolitis

Can people have asthma without attacks?

Anyone who has asthma is at risk of asthma attacks.

An asthma attack is a worsening of someone’s asthma symptoms.

A person may be able to reduce their risk of having an asthma attack by avoiding triggers. However, it is not always possible to prevent asthma attacks.

Wheezing is a common asthma symptom, but not every individual with asthma wheezes.

A person with cough-variant asthma may experience coughing as the sole symptom of the condition.

Someone with classic asthma may experience more silent symptoms, such as shortness of breath and chest tightness.

Anyone with symptoms of a severe asthma attack should seek emergency medical attention.