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Severe Asthma Attacks: Triggers, Symptoms, Treatment, and Recovery

Medically reviewed by Suzanne Falck, MD on October 16, 2017Written by Suzanne Falck, MD on October 16, 2017
severe asthma attacked

Overview

A severe asthma attack is a potentially life-threatening event. Symptoms of a severe attack might be similar to the symptoms of a minor asthma attack. The difference is that severe attacks don’t improve with home treatments.

These events need emergency medical treatment to prevent death. If you suspect you or a loved one is having a severe asthma attack, go to an emergency room right away.

Severe asthma attack symptoms

Symptoms of a severe asthma attack start as a minor asthma attack. You might feel mucus buildup and some chest pain due to your bronchial tubes narrowing. You’ll likely wheeze and cough. Breathing is a challenge, especially during activities like walking. It can be difficult to talk as well.

Given that these symptoms are like a minor asthma attack, what makes a severe asthma attack different? The key is treatment response. You’ll know your asthma attack is severe if your symptoms don’t improve with your routine treatment measures, such as your rescue (“quick-acting”) inhaler. If you use a peak flow meter, reduced flow readings can show the severity of an asthma attack too. According to the Mayo Clinic, a peak expiratory flow (PEF) of between 50 and 79 percent usually means you need treatment.

Other signs of a severe asthma attack can include chest retractions, pale or blue skin, and, in children, drowsiness.

Treatment options for severe asthma

Your asthma treatment depends on how severe your symptoms are on a regular basis. If you have severe asthma, it’s likely that you already take long-term control medications. You may also have a rescue inhaler on hand just in case an asthma attack occurs.

Severe asthma attacks don’t respond to regular asthma treatments, so you need emergency medical treatment if your rescue medications aren’t working. At the emergency room, your medical team may:

  • use a test called a pulse oximetry to tell how much oxygen is in your blood
  • measure your peak flow to determine the rate you exhale
  • take a nitric oxide measurement to determine bronchial tube inflammation
  • measure your forced expiratory volume (FEV) with a spirometry test
  • get a chest X-ray

Once a severe asthma attack is confirmed, your doctor may administer one or more of the following:

  • ipratropium (Atrovent), a type of bronchodilator used when rescue inhalers fail
  • oral or intravenous corticosteroids to control inflammation
  • oxygen
  • magnesium sulfate
  • intubation machines to help you breathe

Recovering from an asthma attack

The goal of treatment is to prevent respiratory arrest. Aside from improving your breathing, asthma attack recovery also depends on how well lung inflammation is controlled. Asthma symptoms occur when your airways are inflamed and constricted. If the underlying inflammation isn’t treated, your bronchial tubes may still constrict and cause problems.

Uncontrolled asthma can also lead to severe attacks. If you frequently rely on your rescue inhaler, this is a sign that you and your doctor need to look at more long-term measures of asthma treatment.

Severe asthma attack triggers

Treatment and recovery are important after a severe asthma attack, as these are both life-saving measures. But the best way to avoid such situations is to prevent severe asthma attacks from happening altogether. Learning your asthma attack triggers is key to prevention.

Not everyone’s asthma symptoms are alike, and everyone has different asthma triggers. It’s important to learn yours so you know what to avoid. Triggers that may exacerbate asthma-related inflammation include:

  • animal dander
  • chemicals (such as cleaners)
  • cold temperatures
  • dry air
  • dust mites
  • heartburn
  • mold
  • perfumes and other fragrances
  • pollen
  • respiratory infections
  • smoke (from tobacco, wood, chemicals, etc.)
  • stress

Still, it’s not realistic to assume that you’ll never come into contact with an asthma trigger. The key is to do your best to avoid any known triggers when, and if, possible. If you have a suspected trigger that hasn’t yet been formally identified, talk to your doctor about testing. You should also have your rescue inhaler with you at all times.

Certain risk factors may also increase your chances of having a severe asthma attack. These include lung disease, a history of severe asthma attacks, and cardiovascular disease.

The bottom line

It’s important to remember that there’s no cure for asthma. Severe asthma attacks are a significant health risk, as these events can quickly turn fatal. What’s more, asthma attacks can interrupt your daily schedule, taking time away from family, work, and leisure activities. Getting your asthma under control means not only a better quality of life, but also an improved outlook on your lung health.

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