Anatomy of an Asthma Attack

  • During an asthma attack, muscles around the airways tighten, and the airway linings swell. Excess mucus secretion is produced in the airways that can block the air tubes and lungs. When air is trapped, breathing becomes difficult. This anterior view of the respiratory system of an asthmatic patient shows a sectioned bronchiole. The airways are narrowed as a result of the inflammatory response cause wheezing.

  • Airborne particles, like those in this colored scanning electron micrograph (SEM) showing the surface of the trachea with breathed in pollen and dust, may cause asthma or allergic rhinitis. In asthmatic or allergic patients, such particles may lead to a hypersensitive reaction causing breathing difficulties.

  • Other important asthma triggers include tobacco or wood smoke; air pollution; dust mites; cockroaches; pets; mold; strenuous exercise; breathing cold, dry air; high humidity; and some foods and food additives.

  • Lack of appetite, fatigue, headache, or a chronic persistent cough often precede an asthma attack. Trouble sleeping and feeling tired are other typical signs, as well as dark circles under the eyes and less tolerance for exercise.

  • Blue or gray lips or fingernails are signs of insufficient oxygen in the blood. The condition is called cyanosis and indicates an emergency situation. Other signs of an asthma emergency include difficulty talking, inability to exhale or inhale, shortness of breath, feelings of anxiety or panic, coughing that will not stop, and a pale, sweaty appearance.

  • A peak flow meter is used to monitor lung function by measuring the maximum rate at which air is expelled from the lungs. The patient takes a deep breath and breathes out as hard as possible into the mouthpiece. This test can be used to detect asthma and other lung disorders. Patients should know their baseline “best breathing” measurement. Peak flow readings between 50% and 80% of a baseline reading indicate onset of an asthma attack, whereas readings below 50% indicate an asthma emergency.

  • People with asthma can prevent asthma attacks if they are taught to use inhaled corticosteroids and other prescribed daily long-term control medicines correctly and to avoid asthma triggers.

  • An asthma action plan, or management plan, is a written plan developed by healthcare providers for patients with asthma that indicates the patient’s medications and specific information on dosing and timing, as well as instructions on how to handle worsening asthma or attacks. Anyone caring for a child with asthma should be aware of the asthma action plan, including babysitters, daycare workers, school teachers and camp counselors.

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Asthma is a lifelong disease that causes wheezing, breathlessness, chest tightness, and coughing, and can limit a person's quality of life. Between 2001 and 2009, the number of people diagnosed with asthma increased by 4.3 million. The cause of growing asthma rates remains unknown, but patients can control their condition by avoiding asthma triggers and using appropriate medications. Learn more about asthma with this slideshow.

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