What's Really Happening During an Asthma Attack?

A flare-up can surprise you—here's how to prevent one.

Medically reviewed in June 2022

According to the Centers for Disease Control and Prevention (CDC), 1 in 13 US adults have asthma, a chronic lung condition that inflames the airways in the body.

People who deal with the disorder on a regular basis are probably familiar with the types of activities and environmental factors that could up their risk of an asthma attack. Things like exercise, smoking, pollution and stress can all trigger a flare-up, and symptoms like coughing, wheezing, shortness of breath or chest tightness can all be signs of an episode. But what's actually going on inside those airways and lungs once asthma kicks into high gear?

Inside your chest
When an attack hits, it affects your body's airways—in other words, the tubes that take air from your mouth and nose to your lungs. As you breathe, the airways change in size. When the attack starts, the airways get inflamed, and it becomes difficult to breathe easy through the smaller space. As the airways flare up, the surrounding muscles become tight, creating an even smaller space for breath to push through.

An episode may cause your body to produce more mucus than usual in the area, clogging things up even more and making you gasp. Pretty scary!

How it's diagnosed
Asthma can be diagnosed by various tests performed by a medical professional. Your doctor may conduct a pulmonary function test or spirometry, which measures how much air you can move in and out of your lungs and how quickly, as well as collect any family history of breathing issues.

In addition to these tests, the doc may also perform general allergy tests, blood tests and chest and sinus X-rays. Not only does it give them a snapshot of your major respiratory areas, but it also helps them rule out other inflammatory conditions, such as allergies, that could be causing inflammation.

Treatment options
Asthma has no known specific cause or cure, but thankfully there are options for treating and managing symptoms to help avoid an attack. A good treatment, or asthma action plan, will help maintain quality lung function and allow you to get more uninterrupted sleep.

People with asthma should also avoid any known triggers—except exercise. Although working out can increase your risk, it's beneficial to your health to stay active. Work with your doctor to find a healthy balance between asthma management and movement in order to stay healthy.

Long-term medication for asthma can come in many forms, including inhaler, injection and pill. These treatments help lower inflammation in the airways, whereas short-term fixes work to relax tight muscles when the asthma attack is happening. They do not help lower inflammation; they give immediate but temporary relief from an episode.

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