Asthma Symptoms: Common Triggers, Testing and When to Be Seen

What it involves

MedlinePlus describes asthma as a chronic lung disease that affects the airways, the tubes that carry air in and out of the lungs. The airways can become inflamed and narrowed, which causes wheezing, coughing, and chest tightness. When symptoms get worse than usual it is called an asthma attack or flare-up. MedlinePlus says the exact cause is unknown; genetics and environment likely play a role.

Who this is for

• Adults who wheeze, cough at night or early in the morning, or feel chest tightness that comes and goes
• Patients whose breathing gets worse with colds, exercise, cold air, smoke, or allergens
• Patients with a diagnosis of asthma who need quick-relief medicine more often than before
• Patients unsure whether their symptoms are asthma, allergies, reflux, or something else

What to expect

• Questions about when symptoms happen, what sets them off, and whether they wake you at night
• A listen to your lungs and a review of your medical history, allergies, and family history
• A plain explanation of what could be causing the symptoms and which tests, if any, make sense
• A plan for triggers, medicines, and follow-up, with a referral for lung testing or to an asthma or allergy specialist if needed

The symptoms of asthma

MedlinePlus lists four main symptoms, which range from mild to severe:

• Chest tightness
• Coughing, especially at night or early in the morning
• Shortness of breath
• Wheezing, a whistling sound when you breathe out

The pattern that points toward asthma

NHLBI says other conditions can cause these symptoms, but in asthma they often follow a pattern. They come and go over time or within the same day, start or worsen with viral infections such as a cold, and are triggered by exercise, allergies, cold air, or breathing fast from laughing or crying. They are also worse at night or in the morning.

Common triggers

MedlinePlus groups asthma triggers by type, and says they differ from person to person and can change over time:

• Allergic asthma, set off by dust mites, mold, pets, pollen, and waste from pests such as cockroaches and mice
• Nonallergic asthma, set off by cold air, certain medicines, household chemicals, colds and the flu, outdoor air pollution, and tobacco smoke
• Occupational asthma, caused by breathing chemicals or industrial dusts at work
• Exercise-induced asthma, which happens during physical activity, especially when the air is dry

Allergies, colds, and medicines

Pollen is one of the allergic triggers on that list, and the seasonal allergies guide covers the nose and eye symptoms that often travel with it. Colds and the flu are also triggers, and the cold vs. flu guide explains how those two illnesses usually differ. The MedlinePlus encyclopedia names aspirin and other NSAIDs among the medicines that can trigger asthma, so tell your provider which pain relievers you use. MedlinePlus notes that people with atopic dermatitis often have asthma or seasonal allergies, a link the eczema guide explains in more detail.

Who is more likely to have asthma

MedlinePlus says asthma affects people of all ages but often starts in childhood. Its risk factors include a parent with asthma, secondhand smoke early in life, certain substances at work, and conditions such as obesity and allergies. The obesity and BMI guide explains how weight is measured and what a provider looks at.

How a provider checks for asthma

MedlinePlus says a provider may use a physical exam, your medical history, and lung function tests such as spirometry, which tests how well your lungs work. NHLBI adds peak flow tests, which measure how fast you can blow air out, and allergy tests if you have a history of allergies. Lung function testing would be arranged through a referral.

Treatment and the action plan

MedlinePlus says you work with your provider on a plan with three parts: ways to avoid your triggers, quick-relief medicines that you carry in an inhaler, and daily control medicines that reduce airway inflammation. NHLBI advises asking for a written asthma action plan, which the MedlinePlus encyclopedia says lists your medicines, your triggers, and when to call your provider. Your provider chooses and prescribes the medicines.

Signs your asthma may be getting worse

NHLBI lists these signs that asthma might be getting worse:

• You have symptoms more often than usual, or they feel worse
• You need your reliever medicine more often than usual
• You wake up at night because of coughing or other asthma symptoms
• You have trouble with usual activities, including exercise

When to call 911 and when to call the office

MedlinePlus says to go to the emergency room or call Emergency Medical Services right away for drowsiness or confusion, severe shortness of breath at rest, severe chest pain, a bluish color to the lips and face, or extreme difficulty breathing. It says to contact your provider right away if symptoms get worse or you are short of breath while talking. See also the shortness of breath evaluation, the persistent cough evaluation, and the sick visit, urgent care or ER guide. Wheezing together with hives can signal a serious allergic reaction, and the hives guide lists the signs that mean call 911.

Sources

• MedlinePlus — Asthma
• MedlinePlus — Asthma (Medical Encyclopedia)
• NHLBI — Asthma Symptoms
• NHLBI — Asthma Diagnosis