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Acute Exacerbation of Asthma

What happens during an acute exacerbation of asthma?

Asthma is a chronic lung disease. The condition causes inflammation and narrowing of the airways. This can affect your airflow.

The symptoms of asthma come and go. When symptoms flare up and get progressively worse, it can be called:

  • an exacerbation
  • an episode
  • an attack
  • a flare-up

Your airways become swollen during an acute exacerbation. Your muscles contract and the bronchial tubes get narrow. Breathing normally becomes more and more difficult.

Even if you’ve had exacerbations before and know what to do, it’s still a good idea to contact your doctor. An acute exacerbation of asthma is serious and can even become life-threatening. That’s why it’s important to recognize the symptoms early and to take appropriate action.

What are the symptoms of an acute exacerbation of asthma?

Symptoms

The symptoms of asthma vary depending on the person. You may not have any symptoms between attacks. The symptoms can range from mild to severe during an exacerbation. They may include:

  • wheezing
  • coughing
  • chest tightness
  • shortness of breath

An asthma attack can pass quickly with or without medication. It can also last for many hours. The longer it goes on, the more likely it is to affect your ability to breathe. The signs and symptoms of an acute exacerbation include:

  • agitation
  • an increased respiratory rate
  • an increased pulse rate
  • decreased lung function
  • difficulty speaking
  • difficulty breathing

These signs and symptoms should be considered a medical emergency. You should call your doctor immediately if any of them occur.

What triggers asthma attacks?

Causes

Asthma attacks can be triggered by a variety of things. Some of the more common triggers are:

  • upper respiratory infections
  • colds
  • pollen
  • mold
  • dust mites
  • pets
  • tobacco smoke
  • cold, dry air
  • exercise
  • gastroesophageal reflux disease

It may be a combination of factors that set off the chain reaction. Despite all of the potential triggers, it’s not always possible to identify the exact cause.

Who gets acute asthma attacks?

Risk Factors

Anyone who has asthma is at risk of having an acute exacerbation. That risk is greater if you’ve had one before, especially if it was serious enough for an emergency room visit. Other risk factors include:

  • using more than two rescue inhalers per month
  • having asthma attacks that come on suddenly
  • having other chronic health problems
  • smoking
  • not using asthma medication as directed
  • having a cold, flu, or other respiratory infection
  • having contact with a trigger such as pollen or mold

Females tend to have more asthma exacerbations than males. African-Americans and Hispanics are admitted to the hospital for exacerbations at a higher rate than Caucasians.

How is an acute exacerbation of asthma diagnosed?

Diagnosis

If you’ve had an acute exacerbation before, you’ll probably recognize the symptoms. Your doctor will be able to make a quick diagnosis.

If it’s your first acute exacerbation, your doctor will need to know your medical history, particularly your history of asthma. Diagnosing the problem will involve a physical exam. Your lung function will also be tested.

There are several tests that may be used to see how well your lungs are working. A peak flow test measures how fast you can exhale. To get a reading, you blow into a mouthpiece as hard as you can. You can also use a peak flow meter on your own at home.

Your doctor may also use a spirometer. It can measure how fast you’re able to breathe in and out. It also determines how much air your lungs can hold. To get these measurements, you have to breathe into a special hose that’s connected to a meter.

Another test that involves breathing into a mouthpiece measures the amount of nitric oxide in your breath. A high level means your bronchial tubes are inflamed.

During a severe attack, it may be necessary to check the level of oxygen in your blood. This can be done using a pulse oximeter. A pulse oximeter is a small device that’s placed on the end of your finger. It takes a few seconds to complete.

How is an acute exacerbation of asthma treated?

Treatment

Most of the time, asthma exacerbations can be managed at home or with a visit to the doctor.

However, acute exacerbations often result in a trip to the emergency room. Emergency treatment may include administration of oxygen, inhaled beta-2 agonists, and corticosteroids.

This type of attack requires close monitoring, and diagnostic tests may be repeated several times. You won’t be discharged until your lungs are functioning adequately. If your breathing continues to be labored, you may have to be admitted for a few days.

You may need to take corticosteroids for several days following the attack. It’s also important to get follow-up care as directed.

What’s the outlook for people with asthma?

Outlook

Fortunately, most people with asthma are able to manage the disease and maintain a good quality of life.

An acute exacerbation of asthma can be a life-threatening event. You should be able to resume your normal activities once it’s under control. Of course, you’ll want to avoid known triggers and follow your doctor’s advice for disease management.

Everyone who has asthma should have an asthma action plan in place. Work with your doctor to come up with a plan so you’ll know what to do when symptoms flare up.

Is there any way to prevent an acute exacerbation of asthma?

Prevention

If you can identify triggers for your exacerbations, you can try to avoid them in the future. Unfortunately, it’s not always easy to figure out what triggers an attack. It’s also not always possible to avoid those triggers.

It’s important to learn how to manage your asthma. By keeping it under control as much as you can, you’ll lower the chances of having an acute exacerbation.

Make sure you have an adequate supply of your medications and follow instructions carefully. Consider getting a peak flow meter for home use.

Tips
  • Know your triggers.
  • Keep an adequate supply of medication on hand.
  • Tell your doctor if your medication isn’t working.
  • Work with your doctor to create an asthma action plan.

Tell your doctor if your medications aren’t working. The dosage can be adjusted, or you can try another medication. The goal is to keep inflammation to a minimum.

Treating an asthma attack without delay may help prevent an acute exacerbation.

If you have a cold or flu, pay attention to symptoms. Get medical help right away if you think you’re having an acute exacerbation. 

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