What are the symptoms of asthma?

Dr. Jeanne Morrison, PhD
Family Practitioner

Individual asthma symptoms can vary widely. You may feel mild wheezing or hear a "whistling" sound when you breathe out. Others may feel a shortness of breath or tightness and pain in the chest area. Heavy coughing is a common symptom, especially at night. It is often severe enough to disturb your sleep.

If you are experiencing asthma symptoms, you should speak with your doctor. These symptoms may indicate asthma. It's especially important to talk to a doctor if you have a family history of allergies or asthma.

If you have already been diagnosed, develop an asthma action plan to manage your asthma. This will help you maintain a healthy daily and long-term life. Symptoms can range in severity and frequency, from mildly bothersome to life-threatening. If you visit the emergency room because of an asthma attack, if your symptoms increase in frequency or severity or disturb your sleep, or if you use your quick-relief inhaler more than 2 days a week, be sure to speak with your doctor. A medical professional can help you identify triggers for your asthma and manage it more successfully.

The hallmark of asthma is usually an uncontrollable cough. Along with the cough, the patient may feel shortness of breath, chest tightness and wheezing. The wheezing may be mild and felt only by the patient or heard by the physician. But, the wheezing can be severe enough to be audible by anyone near the patient.

Dr. Michael T. Murray, ND
Naturopathic Medicine Specialist

Chronic asthma is associated with recurrent attacks of shortness of breath, cough, wheezing and excessive production of mucus. Typically, the asthma patient will show laboratory signs of allergy, including increased levels of eosinophils in the blood, increased serum IgE levels and positive food and/or inhalant allergy tests.

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Common symptoms of asthma include wheezing, coughing, shortness of breath and chest tightness. Sometimes these symptoms come about when you are exposed to asthma triggers, such as dust, pet dander, cold air, viruses and other factors. Talk to your doctor if you have any of these symptoms.

The following are symptoms of asthma:

  • High-pitched cough and wheezing
  • Chest wall sucks in with each breath (called retractions)
  • Grunting at end of each inhalation (this is the body's way of keeping air in the smallest airways so they don't collapse)
  • Nasal flaring
  • Chest pain and/or tightness
  • Fast breathing
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Traditionally, we think of asthma as causing wheezing and shortness of breath. However, asthma causes other symptoms, such as coughing, chest pain and chest tightness. A cough that doesn't go away may be a sign of asthma.

During an asthma attack, the airways in the lungs overreact when people with asthma breathe in a trigger, such as house dust mites, pollen, mildew, tobacco smoke, cold air, and chemicals. This causes damage called inflammation, which makes the airways in the lungs swell and become red. It also makes the muscles around the airways squeeze really tight. This is called bronchoconstriction, which means the airways become narrower, making breathing difficult. The lungs make too much mucus, which also makes it harder to breathe, and causes coughing. All of these things can make the chest feel tight. If the airways are narrow, the air that travels through them makes a noise called wheezing.

You may not have asthma symptoms all of the time. Instead, you may have them only sometimes, or at a certain times of the day. When you have symptoms, it's called an asthma flare-up or asthma attack. Here's what you might see or feel:

  • A cough, especially a cough at night
  • Wheezing, a small whistling sound when you breathe out
  • A tight feeling in your chest
  • Trouble taking a deep breath
  • Skin between the ribs and below the throat pulling in with each breath

As you try to understand how asthma affects you, consider these factors:

  • Type: What types of symptoms do you usually have? For some people with asthma, breathing becomes difficult. Yet for many others, coughing is the only symptom.
  • Time: When do you have symptoms? You may experience symptoms only at night. Or, you may only notice symptoms at certain times of the year. Do you get them when you’re active or at rest?
  • Duration: How long do symptoms last, and how often do you have them? Your symptoms may last only for a few minutes or continue for a few days. You might have them every day, or they may flare up unexpectedly and get worse quickly.
  • Severity: How do your symptoms affect your life? Are they just a bother—or do they stop you from doing the things you want to do?

At different times, your symptoms can be mild or serious. During a serious asthma attack, you may need to see a doctor right away.

Dr. Paul M. Ehrlich, MD
Allergist & Immunologist

Asthma is a moving target. Wheezing and shortness of breath—what doctors call "paroxysmal reversible airway obstruction"—have always been the symptoms that we equate with an asthma attack, but now we know that an attack is much more than this. These symptoms come and go and are usually reversible with medications.

But the problems don't stop there, of course. After the attack subsides, and apparently normal breathing is restored, the asthma is still there. Inflammation, caused by the movement of specialized white blood cells into the lining of the airways, produces swelling.

Asthma can be compared to a pot of water boiling on a stove. Inflammation is the burner underneath the pot. When the asthma gets severe, the pot boils over into an attack. For many years, treatment has focused on reopening the airways and ending the symptoms—in effect turning down the temperature and making sure the water doesn't spill over the sides of the pot.

However, alleviating these symptoms doesn't mean that the heat has been turned off. The residual inflammation may just be simmering under the pot.

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People with asthma may experience the following symptoms:

  • Difficulty breathing/wheezing
  • Fast (rapid) breathing/rapid pulse
  • Shortness of breath, even at rest
  • Chest tightness
  • Coughing
  • Sweating
  • Trouble speaking in full sentences
  • Fatigue or irritability

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.