Signs and Symptoms of an Asthma Attack
Medically reviewed by Susan Russell, MD
An asthma attack is an episode where you experience a worsening of asthma symptoms. Asthma is a chronic lung disease that causes inflamed and narrowed airways, making breathing difficult. Symptoms of asthma include coughing, wheezing, shortness of breath, and chest tightness. These symptoms worsen during an asthma attack, which can be triggered by an allergen, strenuous exercise, or an upper respiratory infection like the common cold.
During an asthma attack, the muscles surrounding your airways constrict (become narrower) and spasm, and mucus production in the airways increases. This makes it difficult to get air into your lungs. An asthma attack can be a terrifying experience—you may feel like there is a heavy weight on your chest or as if you are breathing through a straw as you struggle to bring in enough air.
Asthma attack symptoms may develop suddenly or gradually. Asthma attacks can range from mild to severe and require prompt treatment. More severe asthma attacks can quickly become life-threatening without treatment.
Understanding the signs and symptoms of an asthma attack can help you identify when you are experiencing one and know when to use your asthma medications or seek emergency medical care.
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Early Warning Signs
Some people experience early warning signs that an asthma attack is developing. If you notice these signs, you can take action—such as by using quick-relief asthma medications—and lower your risk of experiencing a severe asthma attack.
Early warning signs of an asthma attack can vary from person to person and may include:
Increased mucus production
Unusual tiredness, weakness, or lack of energy
Stuffy, runny, or congested nose
Itchy neck or chin
Tickle in your chest or throat
Sharp, sudden cough
A feeling as though you can't take a deep breath
Slouched posture or raised shoulders (tense shoulders that are closer to ears than usual)
Mild-to-Moderate Symptoms
A mild-to-moderate asthma attack can bring on concerning symptoms.
If you use a peak flow monitor, a small device to monitor how well air moves out of your lungs, your readings can reveal whether you are or may soon be experiencing a mild or moderate asthma attack. A sign of a mild or moderate asthma attack would be a peak flow rate that's 50-80% of your best peak flow number.
Symptoms of a mild-to-moderate asthma attack can include:
Wheezing: A high-pitched whistling sound during breathing may come and go.
Frequent cough: The cough may worsen at night or during exertion.
Difficulty breathing: You may have trouble taking a deep breath or feel like you can't catch your breath.
Chest tightness: This would feel like pressure, squeezing, or pain in your chest or a feeling of a heavy weight sitting on your chest as you try to breathe.
Shortness of breath: You may feel like you're breathing quicker or can't get enough air, even at rest.
Retractions: The ribs pull in with each breath as you use your stomach muscles to help you breathe.
Neck strain: You can have tightness, discomfort, or strain in your neck muscles as you work harder to breathe.
While a mild or moderate asthma attack can be a frightening experience, using rescue medication like an albuterol inhaler (sold under brand names like Proair and AccunNeb) could help improve symptoms shortly after you take the quick-relief medication. A steroid-albuterol combination can be helpful.
Severe Asthma Attack Symptoms
A severe asthma attack may be a medical emergency. During a severe asthma attack, basic activities like standing or walking may be impossible. Speaking even one-word phrases can be difficult or impossible.
A peak flow monitor reading that's less than 50% of your best rate is a sign of a severe asthma attack.
Symptoms can quickly worsen during a severe asthma attack and may include:
Severe shortness of breath: You could have rapid, shallow breathing or breathing that is slower than usual.
Retractions: The skin around the neck, chest, and rib bones may sink in as you struggle to bring in air during inhalations.
Change in posture: Your shoulders could become hunched.
Chest pain: A crushing sensation or pressure in the chest makes breathing difficult and speaking nearly impossible.
Expanded chest: The chest may appear expanded (similar to how it grows when you inhale) and not deflate when you exhale.
Sweating: You may begin sweating, and your skin may feel cold and clammy.
Change in skin color (cyanosis): Cyanosis is a change in skin tone on the fingertips, fingernails, lips, tongue, and around the eyes when the body doesn't get enough oxygen during breathing. Cyanosis may cause skin to turn a bluish-color in people with lighter skin tones and a gray or whitish-color in people with darker skin tones.
Confusion or drowsiness: As oxygen deprivation worsens, you may become confused, drowsy, or lose consciousness.
A severe asthma attack is a scary experience, but it is crucial to remain as calm as possible and focus on breathing. You should take your quick-relief medication like a rescue albuterol inhaler right away. If your peak flow rate or symptoms don't improve, you should seek immediate medical care.
Symptoms in Infants and Young Children
Recognizing the signs and symptoms of an asthma attack in babies and young children who cannot verbalize their symptoms is especially important for parents and caregivers. Here are the asthma attack symptoms to watch for:
Nasal flaring: The nostrils may open wide (flare) during breathing to bring in more air.
Rapid breathing: Besides a faster breathing rate than usual, you may notice your child's skin sucking in around their ribs or neck as they breathe as well as exaggerated belly movements (retracted breathing).
Difficulty eating: Infants may have trouble sucking during feeding due to breathing struggles.
Wheezing: You might hear a whistling sound as the child breathes.
Cyanosis: A child's skin tone on the fingertips, fingernails, tongue, lips, and around the eyes may change. The skin could look bluish on lighter skin and gray or whitish on darker skin.
Tiredness: Young children may become unusually quiet, lethargic, or uninterested in playing or engaging in their favorite activities.
Grunting: Infants may have short cries or make grunting noises.
Floppiness: Infants in respiratory distress may have a floppy body or bobbing head.
Irritability: Babies and toddlers may become agitated, cranky, or fussy.
When to Contact a Healthcare Provider
In many cases, an asthma attack is manageable at home by using quick-relief medication when you first notice symptoms. There are times when you may not have access to your inhaler or your asthma attack symptoms worsen even after using your medication. An asthma attack can quickly become life-threatening and lead to respiratory failure.
Call 911 or seek emergency medical care if you experience the following symptoms:
Persistent shortness of breath, even during rest
Chest tightness that makes breathing very difficult
Severe wheezing or shortness of breath that doesn't improve after using your inhaler
Agitation, confusion, or inability to concentrate
Hunched shoulders
Strained neck and abdominal muscles
Need to sit or stand to help you breathe more easily
Inability to complete a sentence without pausing to breathe
Blue or grayish-colored lips, fingernails, or fingertips
Even if your asthma attack can be treated at home, you should contact your healthcare provider if you:
Experience asthma symptoms more than twice a week
Use your quick-relief medication more than twice a week
Have disrupted sleep more than twice a month due to your asthma symptoms
Have difficulty carrying out your daily activities like work, school, or hobbies because your symptoms are bothersome
Notice your asthma symptoms are worsening despite following your treatment plan
Questions To Ask Your Provider
Understanding your asthma and potential triggers is essential for managing the condition effectively. To better manage asthma and any asthma attacks you may have, consider asking your healthcare provider the following questions:
Are there any modifications I can make at home or work to lower my risk of an asthma attack?
Along with my rescue inhaler, are there medications I should have on hand in case of an asthma attack?
What should I do if I use my quick-relief inhaler and my shortness of breath does not improve?
What peak flow monitor reading should prompt me to use my quick-relief medication or seek medical attention?
A Quick Review
An asthma attack is the sudden worsening of asthma symptoms, often triggered by allergens, irritants, or illness. Asthma attacks can range from mild to severe.
Early warning signs of an asthma attack include increased mucus production and a sharp, sudden cough. Signs of a mild-to-moderate asthma attack include wheezing, chest tightness, and frequent cough. Cyanosis (skin color changes at the fingernails or lips), confusion, rapid breathing, and sweating are signs of a severe asthma attack.
If your asthma attack symptoms don't improve after taking appropriate steps, such as using your quick-relief asthma medication, reach out for medical care.
Frequently Asked Questions
How long do asthma attacks last?
The duration of an asthma attack varies, depending on the cause and severity of airway inflammation. A mild asthma attack can last minutes, and more severe attacks can last hours or days.
Do you experience any symptoms after the asthma attack is over?
People who've had an asthma attack often report experiencing fatigue and exhaustion afterward that affects their ability to carry out their daily activities. Anxiety and worry are also common in people who have experienced an asthma attack.
How can I stop asthma symptoms if I don't have an inhaler?
When asthma symptoms develop and you don't have an inhaler, you can:
Sit upright and lean slightly forward or sit backward on a chair to ease breathing
Remain calm and breathe slowly and deeply—in through your nose, out through your mouth
Call 911
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