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Asthma attack
Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.
Asthma signs and symptoms include:
• Shortness of breath
• Chest tightness or pain
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu
Signs that your asthma is probably worsening include:
• Asthma signs and symptoms that are more frequent and bothersome
• Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)
• The need to use a quick-relief inhaler more often
For some people, asthma signs and symptoms flare up in certain situations:
• Exercise-induced asthma, which may be worse when the air is cold and dry
• Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
• Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollen
When to see a doctor
Seek emergency treatment
Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:
• Rapid worsening of shortness of breath or wheezing
• No improvement even after using a quick-relief inhaler, such as albuterol
• Shortness of breath when you are doing minimal physical activity
Contact your doctor
See your doctor:
• If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time.
• To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack.
• If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don't try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse.
• To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments.
Causes
By Mayo Clinic Staff
It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors.
Asthma triggers
Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:
• Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
• Respiratory infections, such as the common cold
• Physical activity (exercise-induced asthma)
• Cold air
• Air pollutants and irritants, such as smoke
• Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)
• Strong emotions and stress
• Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
Risk factors
By Mayo Clinic Staff
A number of factors are thought to increase your chances of developing asthma. These include:
• Having a blood relative (such as a parent or sibling) with asthma
• Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
• Being overweight
• Being a smoker
• Exposure to secondhand smoke
• Exposure to exhaust fumes or other types of pollution
• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
Complications
By Mayo Clinic Staff
Asthma complications include:
• Signs and symptoms that interfere with sleep, work or recreational activities
• Sick days from work or school during asthma flare-ups
• Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe
• Emergency room visits and hospitalizations for severe asthma attacks
• Side effects from long-term use of some medications used to stabilize severe asthma
Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.
Preparing for your appointment
By Mayo Clinic Staff
You're likely to start by seeing your family doctor or a general practitioner. However, when you call to set up an appointment, you may be referred to an allergist or a pulmonologist.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Here's some information to help you get ready for your appointment, as well as what to expect from your doctor.
What you can do
These steps can help you make the most of your appointment:
• Write down any symptoms you're having, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Note when your symptoms bother you most — for example, if your symptoms tend to get worse at certain times of the day, during certain seasons, or when you're exposed to cold air, pollen or other triggers.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to recall all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For asthma, some basic questions to ask your doctor include:
• Is asthma the most likely cause of my breathing problems?
• Other than the most likely cause, what are other possible causes for my symptoms?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What's the best treatment?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
• What exactly are your symptoms?
• When did you first notice your symptoms?
• How severe are your symptoms?
• Do you have breathing problems most of the time or only at certain times or in certain situations?
• Do you have allergies, such as atopic dermatitis or hay fever?
• What, if anything, appears to worsen your symptoms?
• What, if anything, seems to improve your symptoms?
• Do allergies or asthma run in your family?
• Do you have any chronic health problems?
Tests and diagnosis
By Mayo Clinic Staff
Appointments & care
At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.
Learn more. Request an appointment.
Physical exam
To rule out other possible conditions — such as a respiratory infection or chronic obstructive pulmonary disease (COPD) — your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems.
Tests to measure lung function
You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include:
• Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
• Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings.
Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma.
Additional tests
Other tests to diagnose asthma include:
• Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal.
• Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed — a sign of asthma — you may have higher than normal nitric oxide levels.
• Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose
• Asthma attackAsthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.Asthma signs and symptoms include:• Shortness of breath• Chest tightness or pain• Trouble sleeping caused by shortness of breath, coughing or wheezing• A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the fluSigns that your asthma is probably worsening include:• Asthma signs and symptoms that are more frequent and bothersome• Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)• The need to use a quick-relief inhaler more oftenFor some people, asthma signs and symptoms flare up in certain situations:• Exercise-induced asthma, which may be worse when the air is cold and dry• Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust• Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollenWhen to see a doctorSeek emergency treatmentSevere asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:• Rapid worsening of shortness of breath or wheezing• No improvement even after using a quick-relief inhaler, such as albuterol• Shortness of breath when you are doing minimal physical activityContact your doctorSee your doctor:• If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time.• To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack.• If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don't try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse.• To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments.CausesBy Mayo Clinic StaffIt isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors.Asthma triggersExposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:• Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites• Respiratory infections, such as the common cold• Physical activity (exercise-induced asthma)• Cold air• Air pollutants and irritants, such as smoke• Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)• Strong emotions and stress• Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throatRisk factorsBy Mayo Clinic StaffA number of factors are thought to increase your chances of developing asthma. These include:• Having a blood relative (such as a parent or sibling) with asthma• Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)• Being overweight• Being a smoker• Exposure to secondhand smoke• Exposure to exhaust fumes or other types of pollution• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturingComplicationsBy Mayo Clinic StaffAsthma complications include:• Signs and symptoms that interfere with sleep, work or recreational activities• Sick days from work or school during asthma flare-ups• Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe• Emergency room visits and hospitalizations for severe asthma attacks• Side effects from long-term use of some medications used to stabilize severe asthmaProper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.Preparing for your appointmentBy Mayo Clinic StaffYou're likely to start by seeing your family doctor or a general practitioner. However, when you call to set up an appointment, you may be referred to an allergist or a pulmonologist.Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Here's some information to help you get ready for your appointment, as well as what to expect from your doctor.What you can doThese steps can help you make the most of your appointment:• Write down any symptoms you're having, including any that may seem unrelated to the reason for which you scheduled the appointment.• Note when your symptoms bother you most — for example, if your symptoms tend to get worse at certain times of the day, during certain seasons, or when you're exposed to cold air, pollen or other triggers.• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to recall all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For asthma, some basic questions to ask your doctor include:
• Is asthma the most likely cause of my breathing problems?
• Other than the most likely cause, what are other possible causes for my symptoms?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What's the best treatment?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
• What exactly are your symptoms?
• When did you first notice your symptoms?
• How severe are your symptoms?
• Do you have breathing problems most of the time or only at certain times or in certain situations?
• Do you have allergies, such as atopic dermatitis or hay fever?
• What, if anything, appears to worsen your symptoms?
• What, if anything, seems to improve your symptoms?
• Do allergies or asthma run in your family?
• Do you have any chronic health problems?
Tests and diagnosis
By Mayo Clinic Staff
Appointments & care
At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.
Learn more. Request an appointment.
Physical exam
To rule out other possible conditions — such as a respiratory infection or chronic obstructive pulmonary disease (COPD) — your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems.
Tests to measure lung function
You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include:
• Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
• Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings.
Lung function tests often are done before and after taking a medication called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma.
Additional tests
Other tests to diagnose asthma include:
• Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal.
• Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed — a sign of asthma — you may have higher than normal nitric oxide levels.
• Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose
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