Symptoms of asthma are due to intermittent reversible obstruction
of airways caused by airway inflammation, airway hyper responsiveness
and muscle spasm.
Clinical hallmark of asthma include
1. Episodic wheezing,
2. Breathlessness or shortness
3. Cough specially at night and sputum production.
4. Chest tightness, pain or pressure.
Between the episodes of asthma symptoms improve or may disappear completely.
Asthma symptoms can vary from mild to severe. Before the attack of asthma occur, there are some early warning signs or symptoms that can tell
the person that the asthma attack is about to occur.
Early warning signs of asthma attack:
asthma attack is usually preceded by certain signs and
symptoms. They are
1. Loosing you breath easily or shortness of breath.
2. Feeling tired or weak.
3. Wheezing or coughing after exercise.
4. Decrease in PEFR reading in Peak flow meter
or lung functions measured by
5. Signs of cold or allergies like itchy throat, running or stuffy nose, headache.
6. Trouble sleeping.
7. Chest tightness.
8. Change in amount, color and thickness of mucus.
According to the American College of Emergency Physicians,
recognizing and responding to the following warning
asthma signs and symptoms can
help people avoid an
Wheezing and/or coughing that disturbs sleep at night;
Having to use a quick-relief inhaler more than twice a week;
Taking time off from work or school due to breathing problems;
Consistently having trouble breathing during physical activity;
Inability to take part in normal, everyday activities;
your doctor immediately if you have any of these symptoms
because there is a need for urgent or emergency care.
Asthma symptoms during asthma attack:
Full blown attack of asthma usually has following symptoms which are usually episodic:
Wheezing. A high pitched whistling sounds
produced when breathing out especially in children. Lack of wheezing and a
normal chest examination do not exclude asthma.
2. Coughing (specially in night).
3. Recurrent breathlessness or Shortness of breath.
4. Tightness of the chest, pain or pressure.
Asthma symptoms vary
from person to person. Some may have all the above asthma symptoms and some may
have few of them. Severity of asthma symptoms may vary in each attack.
Asthma symptoms getting worse:
asthma attack airways become narrow, thus making difficult for the patient to breath air in and out of the lungs. The main cause of airway narrowing are:
1. The muscles surrounding the airways tighten. This narrowing of airway due to muscle spasm is called bronchospasm.
2. Inflammation of airways causing further narrowing.
3. Excessive mucous production, which fill the airways with mucous.
All of these factors bronchospasm, inflammation, and mucus production cause asthma symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities.
Other symptoms of an
asthma episode include some or all of the below:
1. Severe wheezing when breathing both in and out.
2. Coughing that won't stop.
3. Very rapid breathing and nasal flaring (the nostril size increases with each breath, a sign that person is working harder to take each breath.
4. Chest pain or pressure.
5. Tightened neck and chest muscles, called retractions.
6. Trouble focusing and talking.
7. Feelings of anxiety or panic.
8. Pale, sweaty face.
9. Cyanosis causing blue lips or finger nails.
The symptoms of status asthmaticus (Acute severe asthma) may include:
1. Persistent shortness of breath,
2. Inability to speak in full sentences,
3. Patient may be breathlessness even while resting,
4. Patient chest may feel closed,
5. Lips and/or finger nails may have a bluish tint,
6. In acute severe asthma patient may feel agitated, confused, or an inability to concentrate.
7. Patient may hunch his shoulders, sit or stand up to breathe more easily, and strain the abdominal and neck muscles.
8. These are signs of an impending respiratory system failure.
9. Silent chest i.e. no wheezing and coughing
is ominous sign of asthma.
Very severe asthma attacks such as status
asthmaticus may constrict the airways so much that there is very less flow of air in and out of the lungs. Thus there may be no wheezing sound or coughing (silent chest).
Unusual symptoms of asthma:
fatigued, and unable to exercise properly may be a sign or symptom of asthma.
Other unusual symptoms of asthma are:
Chest tightness and difficulty breathing in the early morning hours,
Dry hacking cough (cough-variant asthma),
Anxiety; difficulty concentrating,
Asthma symptoms can
present as vomiting after bout of coughing in a child.
Symptoms of asthma occur or
become worsen in the presence of:
Animals with fur or hair,
House-dust mites (in mattresses, pillows, upholstered furniture, carpets),
Smoke (tobacco, wood),
Changes in weather,
Strong emotional expression (laughing or crying hard),
Airborne chemicals or dusts,
may occur or become worsen at night, making the patient to awake.
Point to remember:
"All that wheeze is not asthma and in very severe asthma there may be no wheeze".
last edited: 01-02-2012