Patients with asthma are familiar with regular bouts of coughing, wheezing, and shortness of breath—but when symptoms suddenly get a lot worse, you may be wondering if you’re having an asthma attack.

An asthma attack happens when your airways become irritated and inflamed, which causes breathing muscles to constrict. Severe asthma attacks can be life-threatening if left untreated. 

Florida Medical Clinic Family Medicine Physician Dr. Cicily Stanton explains everything you need to know about asthma attacks, including early warning signs, what to do during an attack, and how to prevent future episodes.

Early Warning Signs of an Asthma Attack

Asthma attacks don’t always come out of nowhere—sometimes warning signs can show up 1-2 days before an attack. These warning signs can include:

• Feeling easily tired or out of breath
• An increase in coughing or wheezing
• Cold or allergy symptoms (itchy eyes, sneezing, runny nose, congestion, etc.)
• Eczema flare-ups
• Low peak flow meter readings

If you recognize any warning signs, make sure to closely monitor how you feel for a few days. Always carry your inhaler with you and avoid exposing yourself to asthma triggers when possible. That might involve postponing outdoor activities, using an inhaler as a precaution, and limiting strenuous exercise.

If you have a peak flow meter, you can measure your readings before and after using a rescue inhaler. If your peak flow rate is 50-80% of your personal best, you should use your rescue inhaler and see a doctor right away if your breathing doesn’t improve. If your peak flow rate is under 50% of your personal best, you should seek medical attention immediately for an asthma attack.

Symptoms of an Asthma Attack

Asthma attacks have symptoms that resemble regular asthma issues, but may be much more intense than normal. Some of these symptoms include:

• Coughing (may be a dry cough or coughing up mucus)
• Shortness of breath and difficulty breathing
• A wheezing or rattling sound from the chest
• Chest pain or tightness

Furthermore, you may be having an attack if:

• Your rescue inhaler isn’t providing relief
• You feel dizzy, lightheaded, or drowsy
• It’s hard to speak or sleep because you can’t breathe
• You can’t catch your breath or fully inhale
• You feel panicky or anxious

Asthma Attacks vs Panic Attacks

If you have both asthma and an anxiety disorder, it can be hard to tell the difference between an asthma attack and a panic attack. Both cause a feeling of tightness in your chest and difficulty breathing, but wheezing and coughing are typically only associated with asthma attacks. Panic attacks can also cause you to hyperventilate and take in too much oxygen, while asthma attacks significantly decrease your oxygen intake.

Because stress is such a common asthma trigger, living with both an anxiety disorder and asthma can often feel like a vicious cycle. A mental health professional can help you find effective ways to manage stress and reduce the likelihood of a stress-induced asthma attack.

What to Do If You Think You’re Having an Asthma Attack

If you suspect you’re having an attack, follow these steps:

1. Stay calm. Panicking or breathing rapidly can make things worse, so do your best to inhale and exhale evenly. Do not lie down—try to stand or sit upright to keep your airways open.
2. Use your rescue inhaler. Remove the cap and shake the inhaler. Seal your mouth around the inhaler, breathe in 1 puff, and hold your breath for 10 seconds. Repeat this up to 3 more times, waiting 1 minute in between puffs.
3. Call 911 or head to urgent care. If symptoms get worse or don’t improve within a few minutes of using your inhaler, it’s time to see a doctor emergently. While waiting for medical care, take another 1-4 puffs every 20 minutes.

It’s safe to use an albuterol rescue inhaler even if the expiration date has passed. However, the medication inside may not be as effective, so you may need to use more of it to find relief. Don’t use an inhaler that’s been damaged or stored in direct sunlight.

If you don’t have a rescue inhaler, call 911 immediately. In the meantime, try to remain calm and move away from nearby respiratory irritants, like cigarette smoke, pets, or outdoor pollen.

Even if you manage to get an asthma attack under control on your own, you should still visit your family doctor within the next few days. Your doctor can determine if you require additional medications, clinical testing, or if there’s an underlying condition that led to the attack.

How to Prevent Future Asthma Attacks

Asthma attacks can be scary in the moment, but finding a treatment plan that works right for you can help manage your symptoms and prevent future emergencies.

• First, talk to your doctor. Your family doctor can help you monitor your asthma, find ways to manage symptoms day-to-day and check for underlying conditions (like infections) that may make asthma worse.
• Know what triggers your symptoms. You can help prevent asthma attacks by avoiding respiratory irritants, allergens, and other triggers. Attacks can be set off by anything from seasonal allergies to physical exercise to stressful emotions. Talk to your doctor if you’re not sure what causes your symptoms or you’re not sure how to avoid triggers.
• Always keep your rescue inhaler on hand. Don’t leave home without your rescue inhaler even for short periods of time. Keep your medication up to date and stored in a dry place away from direct heat or cold. Don’t store your inhaler in your car.
• Make an action plan with your family. If you’re having an emergency, it’s important that those around you know what to do to help. Your loved ones should know where you keep your rescue inhaler, as well as who to call if you’re experiencing an attack.

Need Help Managing Your Asthma? Talk With a Specialist

Asthma attacks can be scary, but with the right treatment plan, it’s possible to prevent future attacks and keep your symptoms under control. For many people, a family doctor like Dr. Stanton is their biggest resource in managing asthma and preventing attacks. Schedule an appointment with Dr. Stanton today at our office in North Tampa. Virtual appointments are also available.

About Dr. Cicily Stanton

Dr. Cicily Stanton is a Family Medicine Physician at Florida Medical Clinic. As an asthmatic herself, Dr. Stanton is uniquely aware of the challenges this condition can bring. She uses her experience to help her patients find long-term relief.

From asthma control to chronic disease management, women’s health, and more, Dr. Stanton’s goal is to help every patient live their healthiest and happiest life.

Disclaimer: This blog is not intended to substitute professional medical advice. Always talk with your doctor before starting or stopping medications or treatments.