- You may be having an asthma attack if you have extreme shortness of breath, wheezing, coughing, and tightness in your chest.
- Asthma attacks may be caused by allergen triggers like mold or dust, air irritants like smoke, illnesses like the flu, or vigorous exercise.
- You should take an inhaler if you are having an asthma attack, but if you don’t have an inhaler and can’t breathe, call 911.
- This article was medically reviewed by Omid Mehdizadeh, MD, otolaryngologist and laryngologist at the Pacific Neuroscience Institute’s Pacific Eye, Ear & Skull Base Center at Providence Saint John’s Health Center in Santa Monica, CA.
- Visit Insider’s Health Reference library for more advice.
One in 13 Americans have asthma, a condition that causes your airways to swell and makes it harder for you to breathe. When you have an asthma attack, symptoms like coughing or having trouble breathing can become severe and may even be deadly if you are not properly treated. Here’s how to know if you are having an asthma attack and how to treat your symptoms.
Signs and symptoms of an asthma attack
The difference between having asthma and having an asthma attack is the severity of the symptoms. Otherwise, the symptoms, themselves, are mostly the same.
So, if you have asthma, you will likely have had most of the symptoms of an asthma attack already, just in a milder form, says Troy Madsen, MD, a professor of emergency medicine at the University of Utah.
Some of the most common symptoms of an asthma attack include:
- Extreme shortness of breath
- Wheezing
- Coughing
- Tightness in your chest
Causes of an asthma attack
An asthma attack happens when your bronchial tubes, or air passages, become inflamed or blocked. The muscles around these tubes constrict and narrow, making it hard to breathe.
The common causes of an asthma attack are:
- Allergen triggers, such as mold, pets or dust mites
- Air irritants, like smoke, perfume, or chemical smells
- Illnesses like the flu or a respiratory infection
- Vigorous exercise
There are other medical issues that can be confused for an asthma attack - for example, "it can be very difficult to distinguish an asthma attack from an allergic reaction," Madsen says.
In some cases, if you have asthma, having an allergic reaction can actually trigger an asthma attack, Madsen says. This can happen if you breathe in an allergen in the air like pollen or dust.
People who suffer from anxiety attacks may also experience shortness of breath and tightness in their chests, but there are differences in symptoms. Wheezing is a telltale sign of an asthma attack that may not show up in other conditions, Madsen says.
How to treat an asthma attack
The first line of defense for an asthma attack should be an inhaler filled with albuterol, a bronchodilator that relaxes muscles in the air passages. But if one is not available and you are still having difficulty breathing, call 911 immediately.
Use an albuterol inhaler
"The first-line treatment for an asthma attack is an inhaler," says Madsen. If you have severe asthma, it may be helpful to carry your rescue inhaler with you at all times so you're prepared in the event of an asthma attack. People commonly carry their inhaler in their purse, backpack, or pocket.
Quick-acting or "rescue" inhalers generally contain albuterol, a medication that helps to open up your airway. Taking a puff of albuterol should quickly relieve symptoms like wheezing and shortness of breath.
If you are still experiencing asthma symptoms after taking your inhaler, you can take albuterol one more time after 20 minutes. But if you are still feeling extreme shortness of breath after the second treatment, you should go to an urgent care clinic or see your doctor immediately.
Small children, who may have trouble using inhalers, can also take albuterol using a nebulizer, a machine that uses a plastic tube with a mouthpiece to deliver medication in the form of a mist.
If your symptoms are so severe that you are unable to talk due to breathlessness, or your lips or face turn slightly blue, you should get medical help immediately.
If you don't have an inhaler, call 911
If you don't have access to a rescue inhaler, "the number one thing would be to call 9-1-1," says Madsen. You should do this even if it is a moderate asthma attack, as it can escalate quickly, Madsen says.
"While waiting for help, a person should focus on slow, even breathing," Madsen says. To do this, you should:
- Make sure that you have moved away from any asthma triggers like pollen or smoke.
- Sit upright and avoid lying down in order to keep your airway fully open.
- Try slowing down your breath so that you are inhaling for two counts and exhaling for two counts. Taking a breath more than 30 times per minute is considered fast breathing and could exacerbate your symptoms.
- Try breathing in through your nose and out through your mouth to stop yourself from hyperventilating.
Slow breathing may also help to stop you from panicking, which is important, as panicking can trigger hyperventilation and make your condition worse.
Emergency medical treatments
Once you reach the ER, your treatment will depend on how severe your asthma attack is:
- For moderate asthma attacks, your treatment may include:
- Albuterol using a nebulizer, as this can provide medication deeper into your lungs.
- Steroid pills, which can reduce inflammation in your lungs, helping you breathe more easily.
- For severe asthma attacks, you may be treated with:
- Oxygen delivered through a mask, which can help get enough oxygen into your lungs, even if your breathing is still strained.
- In life-threatening cases, you may be placed on a ventilator machine, Madsen says, which will take over your breathing functions while doctors continue to treat the asthma attack.
The bottom line
Though many asthma attacks are mild and can be treated with an inhaler, if you are worried about your symptoms or in doubt, it's best to get emergency help.
"Asthma attacks should not be taken lightly," Madsen says, "if someone is having a severe asthma attack they should not hesitate to call 9-1-1."