The Anatomy of an Asthma Attack: A HealthCentral Explainer

ATsai Editor
  • What causes an asthma attack?

    People with asthma have inflamed airways that react by swelling and narrowing when triggers or allergens are present. Usually, the symptoms progress over several hours or days rather than abruptly developing. In some instances symptoms can be mild and go away on their own, or with minimal treatment, but they also can grow increasingly intense. This is called an exacerbation and it means you are having an asthma attack. Treating symptoms when they first appear can prevent it from developing into a severe asthma attack, which can be fatal.


    Some people experience treatment-resistant asthma, where inhaled steroids no longer work on their lungs, putting them at greater risk for a severe asthma attack. Researchers now think they know why this might happen. A new study from the University of Michigan Health System has found a type of cell in mice that plays a major role in causing asthma, even when a steroid is used. Researchers named the new cell T2M, or type 2 myeloid, and determined that these cells receive specific distress signals from the lungs, and cause inflammation. They also found that a mouse without asthma could develop steroid-resistant asthma if these cells were transferred to its lungs. By studying blood samples of people with and without asthma, the scientists found that a very similar type of cell was present in higher amounts in people with asthma.

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           [SLIDESHOW: 7 Signs You Need to Go to the ER for Your Asthma Attack]


    What happens in the body?

    When the airways react to an allergen or trigger, the muscles around them tighten, narrowing the airway, which causes less air to flow to the lungs. Swelling can also occur, which narrows the airways even further, and cells in the airways begin to produce mucus. Because mucus is a sticky, thick substance, it can also narrow the airways.


    What are the symptoms?

    Wheezing, shortness of breath, dry coughing, chest tightness or pain, rapid heart rate and sweating are all common symptoms of an asthma attack. When shortness of breath is present, it can be very distressing to the person experiencing the attack. Sometimes you can tell someone is having a breathing problem because the use of the muscles at the base of the neck and between the ribs becomes more exaggerated. In some instances, a patient actually might not feel too uncomfortable. But this can be  dangerous because they  may not seek care despite their low oxygen level. When an attack is over, it can be marked by a cough that produces thick, stringy mucus. Inflammation will still be present in the lungs, and can be asymptomatic, but needs to be treated to prevent relapse.


    Are there other symptoms of severe attacks?

    If someone is having a severe asthma attack, it could be life-threatening. The patient may have very shallow breathing, as the chest struggles to bring in enough air to the lungs. The skin can also turn bluish if the body is not getting enough oxygen. The flesh around the ribs may look “sucked in,” and the patient may lose consciousness.


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    Though, as previously stated, symptoms of an asthma attack develop over several hours or days, once an exacerbation is occurring, it is hard to know if it will turn severe, as serious symptoms can rapidly unfold in a few minutes. If any of these severe symptoms are present go to the emergency room as quickly as possible.

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    What should someone having an asthma attack do?

    When symptoms of an asthma attack first appear, it’s important to use a rescue inhaler as soon as possible to the get the attack under control. Relaxing the body, breathing in slowly through the nose and exhaling even more slowly through pursed lips can help. So can a technique called the “wet noodle”, in which you let your body go limp, like a wet noodle, to stay relaxed. If your medicine isn’t reducing your symptoms, you need to go to the emergency room right away.


    How can attacks be prevented?

    Asthma attacks can be prevented by taking your medicine as prescribed. This means taking your daily bronchodilators and anti-inflammatory drugs, which are designed to prevent asthma symptoms, and also using quick-relief inhalers when symptoms do emerge.  In addition, know your triggers, follow an asthma action strategy, and get regular check-ups with the doctor. That  can not only prevent an attack, but help you deal with one if it does happen.

Published On: May 22, 2012