What Is Chest Congestion in Asthma?

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Asthma can cause excess mucus buildup in the lungs that leads to chest congestion. It usually worsens when you have a respiratory infection or when your allergies are acting up, but you can also feel more congested when your asthma is worsening or when you need adjustments in your asthma treatment. Chest congestion from asthma can cause symptoms like coughing, the need to clear your throat, and nasal stuffiness. Thankfully, there are many effective treatments that can help.

When to See a Doctor for Asthmatic Chest Congestion
Verywell / Gary Ferster

Asthmatic Chest Congestion Symptoms

Chest congestion can be an uncomfortable and especially persistent effect of asthma. You may cough up phlegm or you can feel like you need to do so, but can't (or at least not without significant effort). Your breathing might be loud, with the sound of noisy mucus that seems to be coming from your nose, throat, and/or chest.

Chest congestion can also cause a number of bothersome issues including:

  • Trouble sleeping
  • Fatigue
  • Exercise intolerance (fatigue with minimal or moderate physical activity)
  • Coughing
  • Frequently clearing your throat
  • Trouble breathing
  • Wheezing
  • Chest tightness

When you have asthma, you may also have nasal congestion or postnasal drip along with chest congestion.

Associated Symptoms

You might notice chest congestion with your asthma when your allergies act up. You can also have a cough, stuffy nose, runny nose, sneezing, rash, and/or red, itchy, watery eyes when this is the case.

You may experience all of these symptoms, usually along with a fever, if you have a respiratory infection.

When to See a Doctor

Chest congestion can be a nagging effect of asthma. If you are experiencing chest congestion that does not seem to be improving, you should see your doctor.

Since chest congestion in asthma can be a sign that you have an infection or that your asthma or allergies are not well controlled, you might need treatment (or an adjustment in your current regimen) to help relieve the underlying problem.

Causes

There are several aspects of asthma that contribute to chest congestion. The lining of the lungs is altered, with a tendency toward inflammation and mucus production.

Mucus in the respiratory system may be referred to as phlegm. And, while this sticky substance helps trap unwelcome air particles and destroy infectious organisms, excess phlegm leads to congestion wherever it builds up, be that the lungs, throat, or nasal passages.

In addition to this, you can also have a hard time clearing that mucus when you have asthma, which leads to accumulation.

Mucus builds up due to a number of asthma-related factors:

When your bronchi are tight and inflamed, the mucus in your lungs tends to accumulate because it can't clear of the tight passageways out as it normally would.

Contributing Conditions

Infections and allergic rhinitis result in more inflammation and mucus production throughout the respiratory system than usual. This leads to chest, throat, and/or nasal congestion and may trigger an asthma attack. Poorly controlled nasal allergies are, in fact, a common exacerbator of asthma. Up to 80% of people with asthma also have allergies or allergic rhinitis.

When you have an infection, edema (fluid) can develop in the lungs due to excess inflammation—so much so that it can be seen on diagnostic imaging tests. That fluid may cause you to feel congested.

Additionally, asthma-associated mucus buildup in the lungs increases your risk of pneumonia. Infectious organisms (like viruses and bacteria) get trapped in the lungs, where they can multiply and make you sick. You can develop a productive cough as your body attempts to force the phlegm out of your lungs.

Diagnosis

When you have chest congestion with your asthma, your doctor will consider whether you could have allergies or an infection.

They will also consider if you could be having increased exposure to your asthma triggers or worsening of your asthma, especially if you are also having an exacerbation of your other asthma symptoms, such as cough, wheezing, and chest tightness.

You will need a medical evaluation that includes a physical examination and possibly a chest imaging test and/or a sputum culture.

History and Physical Examination

Your physical examination will include checking your vital signs, such as your temperature, pulse, and breathing rate. A fever can be an indication of an infection. Rapid breathing or a rapid heart rate can be a sign of a severe infection or an impending asthma attack.

Your doctor will listen to your breathing sounds with a stethoscope, which will help determine whether your congestion is on one side of the lungs or both.

  • Generally, with asthma and allergies, congestion affects both lungs.
  • Congestion can be limited to one lung or one section of a lung when there is another cause, such as an infection.

Diagnostic Tests

A sputum culture may help identify an infectious organism that could require specific treatment, such as antibiotics or antiviral therapy. These treatments are typically selected to target the specific infection whenever possible.

You might need a chest X-ray or chest computerized tomography (CT) scan, which can identify areas of fluid or lung infection, such as pneumonia or a lung abscess. Infections that cause changes in a chest imaging test can cause severe chest congestion that makes it difficult to breathe and may necessitate hospitalization and intravenous (IV, in a vein) antibiotics.

Treatment

Just as with your overall asthma management, treating chest congestion in asthma is centered on avoiding your asthma triggers and using your maintenance controller asthma medications.

Controller treatment options may include nasal corticosteroids and long-acting bronchodilator inhalers. For example, Flovent (fluticasone propionate) is a corticosteroid; Advair (fluticasone/salmeterol) and Symbicort (budesonide/formoterol) both combine a corticosteroid with a bronchodilator.

When congestion is a major issue in your asthma, you might be prescribed a nebulizer treatment. This is a method of using a mist-producing device that delivers the asthma medication more slowly over a longer period of time than an inhaler.

However, because a nebulizer session takes longer than a using a standard inhaler and requires you to stay in one place until the treatment is done, it can be inconvenient.

Your doctor might also recommend that you use of N-acetylcysteine, an over-the-counter supplement, which helps thin mucus. It is considered safe and has been used in the treatment of chest congestion in asthma.

Medications for Congestion

Mucolytics help decrease the amount of mucus in the respiratory passages. These medications are not generally prescribed long term and they aren't indicated for asthma, given their potential for causing bronchospasm. Nevertheless, your doctor may recommend a mucolytic for a short time when you are dealing with chest congestion until the cause is better controlled.

Expectorants like guaifenesin are mucolytics that work by thinning respiratory mucus. Thinning mucus makes it easier to cough it up and out, helping relieve congestion.

Allergy Treatments

Your doctor might also prescribe leukotriene modifiers or antihistamines for you if you have a lot of allergy symptoms.

If persistent allergies are worsening your asthma and causing chronic congestion, immunotherapy (allergy shots) are an option as well.

Antibiotics

If you have an infection, your doctor might prescribe antibiotics or antiviral therapy to help clear your infection and its associated symptoms, including chest congestion.

You might feel better before your antibiotic course is finished, but it's important that you take the whole prescription so your infection will be completely treated.

Antibiotics are not going to clear up your chest congestion unless it is due to pneumonia or some other bacterial infection.

Lifestyle Modifications

For chronic congestion, at-home strategies like using a Neti pot can help temporarily clear the mucus buildup so you can breathe easier. Having a dehumidifier, especially when it's very damp or muggy, can help as well.

These approaches can provide short-term relief, so you need to be consistent about using them so your chest congestion won't recur.

Specialist-Driven Therapies

Your doctor may also suggest that you participate in pulmonary rehabilitation, which can include breathing exercises to help you breathe deeper. This helps optimize the opening of your airways so you can more effectively clear out mucus.

High-frequency chest oscillation is a procedure that involves using a vest to deliver vibration to the chest from the outside. This technique helps loosens the phlegm and mucus so you can cough it up.

A Word From Verywell

You might be able to get relief from asthma-related chest congestion by more strictly adhering to your asthma treatment plan or, in some cases, modifying it with the help of your doctor. Medications for chest congestion can help make you more comfortable as the underlying cause resolves, and lifestyle strategies can be helpful as well.

But since other factors can contribute to chest congestion, you might need management of these issues as well. See your doctor to be sure you are on the right course.

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