Signs and Symptoms of Asthma

In This Article

Asthma is characterized by symptoms of wheezingcoughchest tightness, and shortness of breath caused by the sudden tightening of airway passages and the overproduction of mucus in the lungs. But even beyond the symptoms themselves, asthma is a complex disease that can produce significant changes in the lung both over the short and long term. This can lead not only to a ​worsening of symptoms but an increase in their frequency.

Learning to read the signs, therefore, is the first step to avoiding the complications of asthma and maintaining your optimal respiratory health.

Frequent Symptoms

The four classic signs of asthma include:

  • Wheezing
  • Coughing
  • Chest tightness
  • Shortness of breath

Wheezing

Wheezing is the whistling or squeaky sound that you may make when you breathe. It is the sign most associated with asthma and the most common reason patients 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 usually indicates poorer asthma control. Wheezing can also occur with a number of other diseases.

Wheezing is differentiated from stridor, decreased airflow that results from obstruction outside the lung. In wheezing, inflammation causes narrowing of the airways inside of the lung, resulting in decreased air flow through the lung.

Coughing

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

If your doctor suspects asthma, you may be asked whether you cough at night or with exercise. In asthma patients, a nighttime cough more than twice 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. Patients 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 as they think they will be unable to adequately breathe.

If it feels like something is sitting on or squeezing your chest, you should talk to your doctor.

Shortness of Breath

Shortness of breath is the feeling of breathlessness and inability to catch your breath that you may experience with asthma. Your doctor 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 and more gradually for others.

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

People experience, and therefore may describe, 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. Additionally, moderate exercise in an obese patient also may lead to shortness of breath with less than expected exertion.

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

Cough-variant asthma can have 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.

Having an itchy chin is one unusual sign of an asthma attack coming on. Why this might happen isn't known, but it is reported enough that it may be on a checklist of symptoms at the doctor's office.

Complications/Sub-Group Indications

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.

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—there is no test available to do so. While wheezing is common—it occurs in 40 to 50 percent 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, parental history of allergies or asthma, high levels of eosinophils in the blood, and food allergy.

Children may stop enjoying playing, sports, or social activities, showing fatigue. A child might complain that her chest hurts as a way of conveying chest tightness. Childhood asthma can lead to delayed growth, and it places the child at higher risk for learning disabilities and obesity.

Pregnant Women

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
  • Congenital malformations
  • Hyperemesis
  • Complicated labor

Asthma medications may be linked to complications, but maintaining good asthma control generally outweighs the risks. Albuterol, beclomethasone, and budesonide have had reassuring outcomes in studies, while oral prednisone has not.

When to See a Doctor or Go to the Hospital

If you haven't yet been diagnosed with asthma, see your doctor 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 easily tired of tasks you can normally complete.
  • 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 doctor 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, revisions 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.

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.

A Word From Verywell

No matter what signs of asthma you are experiencing, make sure that you get them checked out. Not all that wheezes is asthma and many of these symptoms can occur in multiple diseases. It is important that all of your symptoms get evaluated, whether you think you have an explanation for them or not.

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