An asthma attack occurs when the airways become narrower, making it harder to move air in and out of the lungs. Symptoms can worsen suddenly or develop gradually and may include wheezing, coughing, chest tightness and shortness of breath.
Asthma is a long-term condition, but its symptoms can often be controlled with appropriate treatment. The medicines used and how often they are taken depend on the person’s age, the severity of the disease and how well they respond to treatment.
During an attack, people with diagnosed asthma should follow their asthma action plan, including instructions on when to use their reliever medicine and when to seek medical care.
What happens during an asthma attack?
Asthma affects the airways, the tubes that carry air into and out of the lungs.
During an attack, the airway walls can become inflamed and swollen. The muscles around the airways may also tighten, while mucus can further narrow the passages. Together, these changes make breathing more difficult.
Common symptoms include coughing, wheezing, shortness of breath and a feeling of tightness in the chest. Some people have symptoms at night or early in the morning.
The severity of an attack varies. A person may have mild symptoms that improve with their prescribed treatment, while a severe attack can become life-threatening.
How asthma attacks are treated
Treatment depends on the individual and should be based on a healthcare professional’s advice and the person’s asthma action plan.
Quick-relief medicines are used to ease symptoms during an asthma attack. Depending on the treatment plan, these can include inhaled medicines that relax the muscles around the airways.
Long-term controller medicines are used to reduce airway inflammation and lower the risk of future symptoms and attacks. Inhaled corticosteroids are an important part of asthma treatment, while some patients may be prescribed combinations containing other medicines.
Current international guidance increasingly recommends inhaled corticosteroid-containing treatment rather than relying on a short-acting reliever alone. For adults and adolescents who meet the relevant criteria, GINA recommends an inhaled corticosteroid-formoterol approach as the preferred reliever strategy in its treatment tracks.
The appropriate medicine and dose should be determined by a healthcare professional. Asthma medicines should not be shared between people.
Using an inhaler correctly
Correct inhaler technique is an important part of asthma management. Using an inhaler incorrectly can reduce the amount of medicine reaching the lungs.
People who use a metered-dose inhaler may be taught to use a spacer, a device that helps deliver the medicine more effectively. Pharmacists and healthcare professionals can demonstrate the correct technique and check whether a person is using the device properly.
Medication should be taken according to the treatment plan. A person who needs their reliever medicine more often than usual should contact their healthcare provider because increasing reliance on reliever treatment can indicate that asthma is not adequately controlled.
Know what can trigger an attack
Asthma triggers vary from person to person.
Common triggers include tobacco smoke, dust mites, mould, air pollution, pollen and respiratory infections. Exercise, cold or dry air, strong fumes and some allergens can also cause symptoms in some people.
Avoiding known triggers can help reduce attacks, although avoiding every possible trigger is not always practical.
People who are sensitive to cigarette smoke, for example, should avoid exposure to secondhand smoke. Those affected by particular allergens may need advice from a healthcare professional about how to reduce exposure.
Why regular medical reviews matter
Asthma treatment may need to change over time. A healthcare professional can assess symptoms, review medication use, check inhaler technique and determine whether the current treatment is controlling the disease.
Everyone with asthma should have an asthma action plan developed with a healthcare provider. The plan should explain what to do when symptoms are controlled, what to do when they worsen and when to seek urgent medical attention.
Frequent attacks or increasing use of reliever medicine can be a sign that treatment needs to be reviewed.
When an asthma attack becomes an emergency
Not every asthma attack requires hospital treatment, but worsening symptoms should not be ignored.
A person should seek urgent medical care if their symptoms do not improve after using their reliever medicine according to their asthma action plan, or if breathing remains very difficult. Severe symptoms can include marked shortness of breath and difficulty speaking because of breathing problems.
In an emergency department, treatment can include inhaled medicines delivered through an inhaler or nebulizer, corticosteroids and oxygen when necessary. Severe, life-threatening attacks may require intensive respiratory support.
Frequently asked questions
What is asthma?
Asthma is a chronic disease affecting the lungs and airways. It can cause wheezing, coughing, shortness of breath and chest tightness. Symptoms can vary over time and may worsen when a person is exposed to particular triggers.
How do I know if I have asthma?
Symptoms alone cannot establish an asthma diagnosis. A healthcare professional may assess symptoms, medical history and lung function before making a diagnosis.
Anyone experiencing recurring breathing problems should seek medical evaluation rather than assuming that the symptoms are asthma.
Can asthma go away?
Asthma is a long-term condition, although symptoms can change over time. Some people have periods with few or no symptoms, while others continue to need treatment.
The aim of treatment is to control symptoms, maintain normal activity and reduce the risk of serious attacks.
How can asthma be controlled?
Asthma can be managed through appropriate medication, correct inhaler technique, an individualized asthma action plan and efforts to reduce exposure to known triggers.
Treatment should be reviewed with a healthcare professional when symptoms become more frequent, worsen or require increasing amounts of reliever medicine.
