Asthma is caused by swelling (inflammation) in the airways. When an asthma attack occurs, the lining of the air passages swells and the muscles surrounding the airways become tight. This reduces the amount of air that can pass through the airway.
In people who have sensitive airways, asthma symptoms can be triggered by breathing in substances called allergens or triggers.
Common asthma triggers include:
- Animals (pet hair or dander)
- Dust mites
- Certain medicines (aspirin and other NSAIDS)
- Changes in weather (most often cold weather)
- Chemicals in the air or in food
- Respiratory infections, such as the common cold
- Strong emotions (stress)
- Tobacco smoke
Substances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals.
Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.
Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.
Asthma attacks can last for minutes to days. Attacks can become dangerous if airflow is severely blocked.
Symptoms of asthma include:
- Cough with or without sputum (phlegm) production
- Pulling in of the skin between the ribs when breathing (intercostal retractions)
- Shortness of breath that gets worse with exercise or activity
Emergency symptoms that need prompt medical help include:
- Bluish color to the lips and face
- Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack
- Extreme difficulty breathing
- Rapid pulse
- Severe anxiety due to shortness of breath
Other symptoms that may occur:
- Abnormal breathing pattern -- breathing out takes more than twice as long as breathing in
- Breathing temporarily stops
- Chest pain
- Tightness in the chest
Your health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard.
Tests that may be ordered include:
- Allergy testing -- skin or a blood test to see if a person with asthma is allergic to certain substances
- Arterial blood gas (usually only done with people who are having a severe asthma attack)
- Chest x-ray
- Lung function tests, including peak flow measurements
The goals of treatment are:
- Control airway swelling
- Stay away from substances that trigger your symptoms
- Help you to be able to do normal activities without asthma symptoms
You and your doctor should work as a team to manage your asthma. Follow your doctor's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms.
Medicines for Asthma
There are two kinds of medicines for treating asthma:
- Control medicines to help prevent attacks
- Quick-relief (rescue) medicines for use during attacks
These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take them every day for them to work. Take them even when you feel OK.
Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your doctor will prescribe the right medicine for you.
These are also called rescue medicines. They are taken:
- For coughing, wheezing, trouble breathing, or an asthma attack
- Just before exercising to help prevent asthma symptoms caused by exercise
Tell your doctor if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control and your doctor may need to change your dose of daily control drugs.
Quick-relief medicines include:
- Short-acting inhaled bronchodilators
- Oral corticosteroids for when you have an asthma attack that is not going away
A severe asthma attack requires a checkup by a doctor. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV).
Asthma Care at Home
- Know the asthma symptoms to watch for.
- Know how to take your peak flow reading and what it means.
- Know which triggers make your asthma worse and what to do when this happens.
- Know how to care for your asthma when you exercise.
Asthma action plans are written documents for managing asthma. An asthma action plan should include:
- Instructions for taking asthma medicines when your condition is stable
- A list of asthma triggers and how to avoid them
- How to recognize when your asthma is getting worse, and when to call your provider
A peak flow meter is a simple device to measure how quickly you can move air out of your lungs.
It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help let you know when you need to take medicine or other action.
Peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack. Numbers below 50% are a sign of a severe attack.