5 Early Signs You'll Have An Asthma Attack

During an asthma attack, the smooth muscles that control the airflow through the airways become contracted, leading to acute narrowing of the airways. Additionally, the existing inflammation gets much worse, and produces swelling of the airway mucosa. The amount of mucus in the airways increases, both because of excess production and an inability to eliminate it.

Severe acute asthma (Status asthmaticus)

Asthma attacks are usually responsive to treatment. If not to bronchodilators and corticosteroids, then there is aminophylline, and even epinephrine. But if an asthma attack is progressive, severe, and unresponsive to standard treatment, we are talking about severe acute asthma, formerly known as status asthmaticus. These patients require more invasive measures, such as intubation, aggressive treatment, and hospitalization. This condition can lead to long-term consequences, and even death.

What causes asthma attacks?

Most people who suffer from asthma have asthma attacks from time to time. Their frequency, severity, and response to therapy vary among patients. In the majority of cases, patients can predict in which circumstances the attack will occur, based on past experiences and known triggers.

However, others get asthma attacks for no apparent reason, and with no identifiable triggers. There are also specific and universal triggers. For example, if somebody is allergic to birch pollen, and has developed asthma, their asthma attacks will be more frequent during the spring, which is usually the period when the birch pollen concentration is the highest in the air. On the other hand, another person who is allergic to ambrosia will usually have an increased frequency of asthma attacks during late summer or autumn.

What are the early signs of asthma attacks?

In most cases, there will be some indications that asthma attack is about to happen. Patients who have mild to moderate asthma can usually recognize them. However, in some patients with severe asthma, there are no early signs. At least, they don’t appear early enough to try to prevent the attack. An example can be an incidental inhalation of some irritative gas. It might cause a transient cough in a healthy person, but people with asthma easily suffer an unpredictable asthma attack.

The most common early warning signs of an asthma attack include:

• Shortness of breath is the most common symptom of asthma, and also one of the earliest signs you will experience prior to an asthma attack. Mild breathing difficulty, especially when you try to exhale, should be your first clue to grab your inhaler.
• Sweating will not be excessive in the early stage of an asthma attack, but it can appear to some extent. If you start sweating and notice slight breathing difficulties, this can be a sign that the attack is about to happen.
• A wheezing sound can actually appear before you notice any breathing problems. It can be very loud, to the point other people around you can hear it too, especially when you exhale, but as the attack progresses and the airways become narrower, the wheezing usually lowers in intensity.
• Cough is an early sign of asthma attack. It is an attempt to rid your airways of the trigger responsible for the irritation, and also to remove the excess mucus that starts to accumulate in the airways. However, it will not be a successful attempt, not if you don’t help by using your inhaler.
• A feeling of chest tightness appears in most people during an asthma attack, but the earlier you notice it, the better and faster your inhaler will do the job to prevent the progression of the asthma attack.

What to do when you notice the early signs of an asthma attack?

If you are diagnosed with asthma, you are probably already prescribed some inhalers and/or oral medications. Depending on the severity of asthma and common triggers, patients use different dosages of inhalatory corticosteroids or a combination of corticosteroids and bronchodilators in one inhaler. Depending on patient health status and presence of other disorders, your doctor can prescribe either beta-agonists (albuterol), or anticholinergics (ipratropium bromide) for bronchodilatation.

Therefore, if you have the inhaler with you, you should do two things:

• Use the inhaler as prescribed for asthma attacks.
• Try to move away from the trigger. If the air is cold, get inside. If there is an allergen around, try to get away from it. Although histamine is not the main mediator in developed asthma, taking an antihistamine drug is recommended if you know that your asthma is allergic, and if you have been exposed to the responsible allergen.