Recognizing An Asthma Attack

What Is an Asthma Attack?

An asthma attack is a sudden worsening of asthma symptoms caused by the tightening of muscles around your airways (bronchospasm). During the attack, the lining of the airways becomes swollen or inflamed and more and thicker mucus than normal is produced. All of these factors -- bronchospasm, inflammation, and mucus production -- cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath and difficulty performing normal daily activities. Other symptoms of an asthma attack include:

• Severe wheezing when breathing both in and out
• Coughing that won't 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
• Or worsening symptoms despite use of your medications

Some people with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms, due to exposure to asthma triggers or perhaps from over doing it during exercise.

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

What Happens If an Asthma Attack Goes Untreated?

Without immediate treatment, your breathing will become more labored, and wheezing may get louder. If you use a peak flow meter at this time, your personal best reading will probably be reduced.

As your lungs continue to tighten, you will be unable to use the peak flow meter at all. Gradually, your lungs will tighten so much that there is not enough air movement to produce wheezing. This is sometimes called the "silent chest," and it is a dangerous sign. You need to be transported to a hospital immediately. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.

If you do not receive adequate treatment, you will eventually be unable to speak and will develop a bluish coloring around your lips. This color change, known as "cyanosis," means you have less and less oxygen in your blood. Without immediate aggressive treatment in an intensive care unit, you will lose consciousness and eventually die.

How Do I Recognize the Early Signs of An 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 signs are not severe enough to stop you from going about your daily activities. But by recognizing these signs, you can stop an asthma attack or prevent one from getting worse.

Early warning signs include:

• Frequent cough, especially at night
• Reduced peak flow meter readings
• Losing your breath easily or shortness of breath
• Feeling very tired or weak when exercising
• Wheezing or coughing after exercise
• Feeling tired, easily upset, grouchy or moody
• Decreases or changes in lung function as measured on a peak flow meter
• Signs of a cold, or allergies (sneezing, runny nose, cough, nasal congestion, sore throat and headache)
• Trouble sleeping

The severity of an asthma attack can escalate rapidly, so it's important to treat these symptoms immediately once you recognize them.

What Do I Do If I Have An Asthma Attack?

If you are experiencing an asthma attack and your symptoms do not improve after following your asthma action plan contact your doctor and follow the "Red Zone" or emergency instructions immediately. You need medical attention right away.

How We Breathe: Understanding How Your Lungs and Respiratory System Work

You usually don't even notice it, but twelve to twenty times per minute, day after day, you breathe. Your lungs expand and contract, supplying life-sustaining oxygen to your body and removing from it, a waste product called carbon dioxide.

The Act of Breathing

Breathing starts at the nose and mouth. You inhale air into your nose or mouth and then, it travels down the back of your throat, into your windpipe, or trachea. Your trachea then divides into two air passages called bronchial tubes.

One bronchial tube leads to the left lung, the other to the right lung. For your lungs to perform their best, these airways need to be open during inhalation and exhalation, and free from inflammation or swelling and excess or abnormal amounts of mucus.

As the bronchial tubes pass through the lungs, they divide into smaller air passages called bronchioles. The bronchioles end in tiny balloon-like air sacs called alveoli.

Your body has over 300 million alveoli.

The alveoli are surrounded by a mesh of tiny blood vessels called capillaries. Oxygen from the inhaled air passes through the alveoli walls and into the blood.

After absorbing oxygen, the blood leaves the lungs and is carried to your heart. Your heart then pumps it through your body to provide oxygen to the cells of your tissues and organs.

As the cells use the oxygen, carbon dioxide is produced and absorbed into the blood. Your blood then carries the carbon dioxide back to your lungs through the capillaries, where it is removed from the body when you exhale.

Now Breathe In

Inhalation and exhalation are the processes by which the body brings in oxygen and expels carbon dioxide. This process is aided by a large dome-shaped muscle under the lungs called the diaphragm.

When you breathe in, the diaphragm contracts, creating a vacuum that causes a rush of fresh air into the lungs.

The opposite occurs with exhalation, where the diaphragm relaxes and the lungs deflate.

Clearing the Air

The respiratory system has built-in methods to prevent harmful substances in the air from entering the lungs.

Small hairs in your nose, called cilia, help filter out large particles. Cilia are also found along your air passages and move in a sweeping motion to keep the air passages clean. But if harmful substances, such as cigarette smoke, are inhaled, the cilia stop functioning properly, causing health problems like asthma.

Mucus produced by cells in the trachea and bronchial tubes keeps air passages moist and aids in stopping dust, bacteria and viruses, allergy-causing substances, and other substances from entering the lungs.

Impurities that do reach the deeper parts of the lungs can be moved up via mucous and coughed out or swallowed.

Asthma Basics

There are three major features of asthma:

1. Airway obstruction. During normal breathing, the bands of muscle that surround the airways are relaxed, and air moves freely. But in people with asthma, allergy-causing substances and environmental triggers make the bands of muscle surrounding the airways tighten, and air cannot move freely. Less air causes a person to feel short of breath, and the air moving through the tightened airways causes a whistling sound known as wheezing.

(Fortunately, this airway narrowing is reversible, a feature that distinguishes asthma from other lung diseases such as bronchitis or emphysema.)

2. Inflammation. People with asthma have red and swollen bronchial tubes. This inflammation is thought to contribute greatly to the long-term damage that asthma can cause to the lungs. And, therefore, treating this inflammation is key to managing asthma in the long run.

3. Airway irritability. The airways of people with asthma are extremely sensitive. The airways tend to overreact and narrow due to even the slightest triggers such as pollen, animal dander, dust or fumes.

Who Gets Asthma?

Asthma affects 12-15 million Americans, including approximately 10%-12% of children under age 18. Asthma may occur at any age, although it's more common in younger individuals (under age 40).

People who have a family history of asthma have an increased risk of developing the disease. Asthma is also more common in people who have allergies or who are exposed to tobacco smoke.

However, anyone can develop asthma at any time.

What Causes Asthma?

People with asthma have very sensitive airways that react to many different things in the environment called "triggers." Contact with these triggers cause asthma symptoms to start or worsen. The following are common triggers for asthma:

• Infections (colds, viruses, flu, sinus infection)
• Allergens such as pollens, mold spores, pet dander and dust mites
• Irritants such as strong odors from perfumes or cleaning solutions, air pollution,
• Tobacco smoke
• Exercise or exertion
• Weather -- changes in temperature and/or humidity, cold air
• Strong emotions such as anxiety, laughter or crying, stress

What Are the Symptoms of Asthma?

People with asthma experience symptoms when their airways tighten, swell up, or fill with mucus. Common symptoms include:

• Coughing, especially at night
• Wheezing (a high-pitched whistling sound when breathing out)
• Shortness of breath
• Chest tightness, pain, or pressure

Not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your symptoms may also vary from one asthma attack to the next, being mild during one attack and severe during another.

An asthma attack is a sudden worsening of symptoms.

How Is Asthma Diagnosed and Treated?

If you suspect that you may have asthma, see your doctor. He or she can run tests to determine if you have it.

If a diagnosis is made, there are many treatments available to make you feel better and improve the underlying problems that caused the asthma.