The anatomy of an asthma attack

1. The Anatomy of
an Asthma
Attack
By Madeline Vann, MPH | Medically reviewed by Lindsey Marcellin MD,
MPH
Learn how to recognize when an asthma
attack is coming on,
what you can do to prevent it, and how
to get the right medical care.
ParentingTips for Helping Kids With Asthma
Common asthma symptoms such as wheezing and
shortness of breath can progress into a full-blown asthma
attack if you don’t take the right steps early on. Knowing
the first signs of an asthma attack and understanding its
composition will help you make the right decisions about

2. your care.
An asthma attack usually begins when common asthma
symptoms suddenly take a turn for the worse. These
symptoms can include:
• Wheezing
• Shortness of breath
• A feeling of tightness in your chest
• Fatigue
• Coughing at night or early morning
If these symptoms become severe or more frequent, you
may be having an asthma attack, which can turn
dangerous. If an attack reaches the point where you are
unable to breathe while walking or talking, you should go
to an emergency room for treatment.
“An asthma attack feels like you’re trying to breathe
underwater,” explains Houston resident Melissa
McDonald, who has been living with allergic asthma since
age 4. If you have never been diagnosed with asthma, but
think you may have this condition or think you have
experienced an asthma attack in the past, you should talk
to your doctor. You will need to get an accurate diagnosis
and then develop anasthma action plan so that you know
what to do in the future.
“If people have asthma symptoms more than two days a
week, or [are] awakening from asthma more than two
nights a month and are not on any medication, they
should be,” says Robert F. Lemanske Jr., MD, head of the
Division of Pediatric Allergy, Immunology, and
Rheumatology and professor of pediatrics medicine at the
University of Wisconsin School of Medicine and Public
Health in Madison, Wis.
Asthma attacks occur when your airways become swollen
and irritated, making it hard for enough air to get in and

3. out of your lungs. Doctors may use the term “asthma
exacerbation” to describe this situation. In the lungs of
people with asthma, the inside of the small airways tend to
be very reactive — meaning the airways may constrict
tightly during an asthma attack. But constriction isn’t the
only problem. These airways also become inflamed and
swollen. The exact cause of asthma is not known, but it is
probably a combination of genetic risk and environmental
factors.
Asthma attacks often occur in response to “triggers,” or
elements in your environment that increase the irritation in
your airways. Triggers are different for different people.
You may be able to tell immediately if something causes
asthma symptoms, or you might need to be tested for
allergies to find out what is causing your symptoms.
Some of the most common asthma triggers are:
• Smoke (from tobacco, wood, incense)
• Ozone
• Nitrogen dioxide (from gas heaters, stoves)
• Dust mites or cockroaches
• Mold or mildew
• Pet dander
• Hearty exercise
• Strong emotions
• Stress
The best way to manage asthma attacks starts with trying
to prevent them:
• Eliminate triggers. Once you know what triggers your
asthma, do your best to avoid those things. You
might have to be more rigorous about keeping a
clean house or avoiding smokers, for instance. Your
strategies will depend on your specific triggers.
• Take your asthma meds. These drugs may prevent an
asthma attack, even if you can’t avoid triggers.

4. • Treat asthma symptoms early. If you do start to feel
symptoms increasing, you may be able to prevent or
lessen an asthma attack by getting away from any
triggers in your environment and using your
prescribed rescue medications, such as an albuterol
inhaler.
• Get additional help. If your asthma symptoms get
worse or increase in number and you have been
unable to prevent a full asthma attack, call your
doctor’s office or go to the nearest emergency room
for medical help. “You should not take extra puffs of a
rescue inhaler,” says Richard Castriotta, MD,
professor of medicine and associate director of the
Division of Pulmonary, Critical Care, and Sleep
Medicine at the University of Texas Houston Medical
School. “If that isn’t working, go to the ER.”
Asthma attacks can’t always be prevented, but with
guidance from your doctor, you can learn to respond
quickly to manage them. When talking to your health care
provider, be sure you understand the limitations of home
treatment and at what point you must get emergency
medical attention.
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