Signs and Symptoms of Asthma

The characteristic symptoms of asthma—wheezing, cough, chest tightness, and shortness of breath—are caused by the sudden tightening of the bronchi (airways) and the production of too much mucus in the lungs. Besides these symptoms, asthma can cause significant changes in the lungs over the short term and long term. This can make symptoms become more frequent and severe.

Woman using inhaler
 Tim Robberts / Getty Images

Learning to read the signs, therefore, is the first step to avoiding the complications of asthma and maintaining your respiratory health. This article will explain what symptoms to look for and when to see a healthcare provider.

Frequent Symptoms

The four classic signs of asthma are:

Wheezing

Wheezing is a whistling or squeaky sound produced when you breathe. It is the sign most associated with asthma and the primary reason people and parents seek care when concerned about asthma.

Wheezing is usually heard when you breathe out, but can also be heard when you breathe in, which often is an indication of poor asthma control. It occurs when inflammation causes bronchoconstriction (narrowing of the airways) that interferes with the flow of air.

Wheezing should not be confused with stridor, a high-pitched noise that's a hallmark symptom of croup, a common viral infection in children. Stridor results from a decrease in airflow caused by an obstruction outside the lung.

Coughing

Coughing is one of the classic signs of asthma, especially if it is worse at night or interferes with sleep. A chronic cough can also be a sign of poor asthma control.

If your healthcare provider suspects asthma, you may be asked if you cough at night or when you exercise. In those with asthma, a nighttime cough two or more times per month may mean you need to step up your asthma medications.

Chest Tightness

Chest tightness may occur along with the other classic asthma symptoms or all alone. People generally describe it as the very uncomfortable feeling of air not moving in their lungs. Many commonly say, "I just feel tight." This can cause a significant amount of anxiety.

When to Call 911

If it feels like something is sitting on or squeezing your chest, you should talk to your healthcare provider. If the tightness is severe, seek immediate medical care. In addition to being a sign of a possible asthma attack, chest symptoms can be a sign of a heart attack. Both are potentially life-threatening emergencies.

Shortness of Breath

Shortness of breath is the feeling of breathlessness and inability to catch your breath. Your healthcare provider may refer to it as dyspnea, while others may call it "air hunger" or the sensation of not being able to catch your breath. The symptom may come on suddenly for some with asthma and more gradually for others.

This classic asthma symptom can be experienced before diagnosis or be a sign of poor asthma control.

People experience shortness of breath differently. Some patients are not able to do as much activity as they were in the past, finding themselves out of breath much sooner than usual with exertion. Others may notice chronic tightness in the chest, while still others may feel like they need to breathe in again before they're done exhaling.

Shortness of breath is never normal, but it is also not unexpected with very strenuous exercise or travel to high altitudes.

Symptom Pattern

The typical pattern of asthma symptoms is that they come and go, even in the same day, but often are worse at night or in the morning. If you get a cold or another viral infection, your asthma symptoms will often worsen. Symptoms are often triggered by allergies, cold air, exercise, or breathing fast.

Rare Symptoms

A type of asthma called cough-variant asthma can cause a chronic dry, hacking cough without wheezing. Frequent yawning or sighing is another symptom that your body isn't able to breathe normally. Fast breathing (every two seconds or less in adults) is another sign that you aren't getting enough air in or out.

The impairment in your breathing can lead to difficulty in sleeping and concentrating. You might also have anxiety and increased fatigue.

Complications of Asthma

One of the long-term complications of uncontrolled asthma is airway remodeling, which is the permanent narrowing of the bronchial tubes. The normal tissues are replaced by scar tissue. Breathing difficulties similar to chronic obstructive pulmonary disease (COPD) can result.

Some groups are at risk of particular asthma complications.

Infants and Children

Childhood and infant asthma are common. In addition to potentially having the same symptoms seen in adults, infants may have difficulty feeding and may grunt during feeding.

However, asthma cannot be definitively diagnosed in infants, because there is no test available to do so. While wheezing is common—affecting 40% to 50% of babies, especially when they have a respiratory infection—it could disappear as your child ages.

Infants are evaluated for asthma risk factors according to the asthma predictive index, which includes:

  • Atopic dermatitis (eczema)
  • Parental history of allergies or asthma
  • High levels of immune cells called eosinophils in the blood
  • Food allergies

Children may stop enjoying playing, sports, or social activities because they tire easily. A child might complain that their chest hurts. Childhood asthma can lead to delayed growth, and it places the child at higher risk for learning disabilities and unhealthy weight.

Pregnant People

Poorly controlled asthma during pregnancy decreases oxygen levels for both the mother and the fetus. This can lead to any of the following complications:

  • Infant death
  • Preterm delivery
  • Low birth weight
  • Miscarriage
  • Bleeding before and after delivery
  • Depression
  • Preeclampsia or pregnancy-induced hypertension
  • Blood clots or pulmonary embolism
  • Birth defects
  • Hyperemesis (excessive nausea and vomiting)
  • Complicated labor

Some asthma medications may be linked to pregnancy complications, but maintaining good asthma control generally outweighs the risks.

When to See a Healthcare Provider

If you haven't yet been diagnosed with asthma, see your healthcare provider if you have frequent wheezing or coughing that lasts for more than a few days.

If you are diagnosed with asthma, you will then work on keeping your condition under control and monitoring your condition to see if it is getting worse rather than better. When asthma is not well controlled, you can likely expect to experience one or more of the following:

  • You become more aware of your wheezing.
  • You develop a cough that won't go away.
  • You cough more at night or in cold weather.
  • You cough or wheeze with physical activity.
  • You get less relief from quick-relief medications.
  • You have more trouble falling asleep or getting a good night's rest.
  • You get tired more easily than usual.
  • Your allergy symptoms (e.g., runny nose, itchy eyes) worsen.
  • You are less able to identify when an attack is about to begin.
  • You have a downturn in your peak expiratory flow rate (PEFR).

If you have any of these symptoms, see your healthcare provider to determine whether there have been significant changes in your respiratory health. Spirometry and other tests may be used to evaluate the extent of these changes and what, if any, changes to your treatment plan need to be made.

If your asthma symptoms become even more severe, you may reach a point where your symptoms are causing you significant distress and making it difficult for you to function in your everyday life. If left untreated, respiratory distress can lead to serious complications and even death. Don't take a chance. Seek care as a matter of urgency.

Emergency Symptoms

Go to the emergency room if any of the following occur:

  • You have severe wheezing while breathing in and out.
  • You are breathing extremely fast (tachypnea).
  • You are short of breath while talking or have difficulty talking.
  • You are sweating profusely as you labor to breathe.
  • You have a blue-ish tinge to your fingertips or lips (cyanosis).
  • You are unable to perform a PEFR.
  • You have the feeling of impending doom or panic.

Summary

The main and most common symptoms of asthma are wheezing, cough, chest tightness, and shortness of breath. Yawning, fast breathing, and fatigue are other signs your body isn't able to get enough air. Trouble breathing can lead to problems with sleep and concentration.

Your asthma may not be well controlled if you cough or wheeze with exertion, you're more tired than usual, or your medications don't seem to work as well as they used to. Seek emergency help if your wheezing, shortness of breath, or chest tightness are severe.

A Word From Verywell

No matter what signs of asthma you are experiencing, make sure that you get them checked out. Not all wheezing is a sign of asthma and many of these symptoms can occur with other conditions. It is important to get all of your symptoms evaluated, whether you think you have an explanation for them or not.

Was this page helpful?
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ullmann N, Mirra V, Di marco A, et al. Asthma: differential diagnosis and comorbidities. Front Pediatr. 2018;6:276. doi:10.3389/fped.2018.00276

  2. Niimi A. Cough and asthma. Curr Respir Med Rev. 2011;7(1):47-54. doi:10.2174/157339811794109327

  3. Shen H, Hua W, Wang P, Li W. A new phenotype of asthma: chest tightness as the sole presenting manifestation. Ann Allergy Asthma Immunol. 2013;111(3):226-7. doi:10.1016/j.anai.2013.06.016


  4. Löwhagen O. Diagnosis of asthma - a new approach. Allergy. 2012;67(6):713-7. doi:10.1111/j.1398-9995.2012.02821.x


  5. Centers for Disease Control and Prevention. Common asthma triggers.

  6. Fehrenbach H, Wagner C, Wegmann M. Airway remodeling in asthma: what really mattersCell Tissue Res. 2017;367(3):551-569. doi:10.1007/s00441-016-2566-8

  7. Zhang L, Lasmar LB, Castro-Rodriguez JA. The impact of asthma and its treatment on growth: an evidence-based review. J Pediatr (Rio J). 2019;95 Suppl 1:10-22. doi:10.1016/j.jped.2018.10.005

  8. Murphy VE. Managing asthma in pregnancy. Breathe (Sheff). 2015;11(4):258-67. doi:10.1183/20734735.007915