You Can't Self-Diagnose Asthma, But These Signs And Symptoms Should Make You Run To The Doctor

The symptoms of asthma are caused by airway inflammation and reversible obstruction. This means that patients with asthma will have very similar — even identical — symptoms as people with other obstructive pulmonary disorders (chronic bronchitis, emphysema). The only difference is that these symptoms in asthma patients will dissipate in absence of triggers such as allergens or cold air. That's the reason it is called a reversible obstruction.

This article serves a glimpse into the most characteristic symptoms associated with risk factors for developing asthma, but in no way should you try to self-diagnose or self-treat of asthma before visiting your doctor. The process of diagnosing asthma follows the basic principles of making diagnoses in medical practice. It includes patient history, physical examination, lung function tests, allergy testing, and sometimes additional laboratory tests and chest X-rays.

What are the signs and symptoms of asthma?

First, let’s get these two terms straight. Laypeople and even medical professionals sometimes use them as synonyms, but there is a difference between signs and symptoms.

Symptoms are a patient’s subjective complaints — only a patient can determine what their symptoms are, and report them to a doctor. Signs, on the other hand, are objective. Medical professionals can observe them right alongside patients and other people. Examples of symptoms would include chest pain, breathing difficulties, and fatigue, while some examples of signs are a skin rash, use of accessory breathing muscles, and loud wheezing.

What are the most common symptoms of asthma?

• Shortness of breath (dyspnea). People with asthma often report that it is more difficult for them to exhale than to inhale. This is because inhalation always requires the contraction of the diaphragmatic muscle, while exhalation should be a passive process. However, if there is an airway narrowing and obstruction, exhalation becomes a forced action too.
• Wheezing sound. Wheezing can appear during the entire respiratory cycle, but in asthma patients, it is usually much more pronounced while exhaling. Narrowed bronchi and mucus stand in the way of normal airflow, and produce a characteristic wheezing sound.

• Cough. Accumulated mucus and inflammation make the airways hypersensitive and cause a cough, which can be productive or dry depending on the viscosity of the mucus. Cough is one of the most common symptoms in asthma patients, and many external factors can trigger it, such as the presence of allergens, cold air, and respiratory tract infections.
• Chest pain. People with asthma often describe a sensation of chest tightness, pressure, or even pain, especially during asthma attacks. It usually comes from the chest wall structures, such as intercostal muscles, ribs, and the joints between the rib cartilage and the sternum. All these structures are in distress because of intense cough and prolonged effort to maintain the breathing cycle.

What are the most common signs of asthma?

• Sweating. Breathing with airway obstruction produces excess sweating, not only during asthma attacks when patients are practically “fighting for air”, but also whenever lung volumes and capacities dip below the normal range. In those circumstances, breathing becomes a strenuous activity, and it therefore causes excessive sweating — like you might expect in someone who has just been working out.  
• Use of auxiliary breathing musculature. In a healthy person, the breathing muscles are engaged in the inspiration phase of the respiratory cycle. These include the diaphragm (the most important breathing muscle), external intercostal muscles, and scalene muscles. The accessory inspiratory muscles are sternocleidomastoid, serratus anterior, latissimus dorsi, and several other muscles. On the other hand, expiration is a passive phase, and in a healthy person, it does not require the engagement of any muscles. The expiratory phase is the most troubling for asthmatic patients, so they need to use auxiliary expiratory muscles — internal intercostal muscles, front and lateral abdominal wall muscles, and serratus posterior inferior muscle.
• Skin rash. Most people with asthma suffer from the allergic form of this disease. This means that they are also susceptible to other allergy reactions, the most common being an allergic skin rash (allergic urticaria). Angiedema is another, more serious, allergic reaction, while anaphylactic shock represents the most severe and life-threatening allergic reaction which requires immediate treatment.

Asthma and some other, more severe diseases share some of these common symptoms. Chest pain, cough, and breathing difficulties are frequently found in patients with severe cardiovascular diseases, such as coronary artery disease and heart attack. They are more common in older people, but there are no strict rules.