BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuAsthmaBronchial asthma; Wheezing - asthma - adultsAsthma is a chronic disease that causes the airways of the lungs to swell and narrow. It leads to breathing difficulty such as wheezing, shortness of breath, chest tightness, and coughing.Related video goes here for no-HTML5 browsers Causes Asthma is caused by swelling (inflammation) in the airways. An asthma attack occurs when the lining of the air passages has become swollen and the muscles surrounding the airways become tight. This narrowing reduces the amount of air that can pass through the airway.Previous imagePlay SlideshowStop SlideshowNext image / Asthma symptoms can be caused by breathing in substances called allergens or triggers, or by other causes.AllergensAn allergen is a substance that can cause an allergic reaction. In some people, the immune system recognizes allergens as foreign or dangerous. As ...ImageRead Article Now Book Mark Article Common asthma triggers include:Animals (pet hair or dander) Dust mites Certain medicines (aspirin and other NSAIDs) Changes in weather (most often cold weather) Chemicals in the air (pollution) or in food Physical activity Mold Pollen Respiratory infections, such as the common cold and many other viruses Common coldThe common cold most often causes a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms....ImageRead Article Now Book Mark Article Strong emotions (stress) Tobacco or other inhalant that is smokedSubstances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals.Occupational asthmaOccupational asthma is a lung disorder in which substances found in the workplace cause the airways of the lungs to swell and narrow. This leads to ...ImageRead Article Now Book Mark Article Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.AllergiesAn allergy is an immune response or reaction to substances that are usually not harmful.ImageRead Article Now Book Mark Article Allergic rhinitisAllergic rhinitis is a diagnosis associated with a group of symptoms affecting the nose. These symptoms occur when you breathe in something you are ...ImageRead Article Now Book Mark Article EczemaAtopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy rashes. It is a type of eczema. Other forms of eczema include...ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / Symptoms Asthma symptoms vary from person to person. For example, you may have symptoms all the time or mostly during physical activity. Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Wheezing or a cough may be the main symptom.Related video goes here for no-HTML5 browsersAsthma attacks can last for minutes to days. An asthma attack may start suddenly or develop slowly over several hours or days. It may become dangerous if airflow is severely blocked.Symptoms of asthma include:Cough with or without sputum (phlegm) production CoughCoughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...ImageRead Article Now Book Mark Article Pulling in of the skin between the ribs when breathing (intercostal retractions) Intercostal retractionsIntercostal retractions occur when the muscles between the ribs pull inward. The movement is most often a sign that the person has a breathing probl...Read Article Now Book Mark Article Shortness of breath that gets worse with exercise or activity Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Whistling sound or wheezing as you breathe Pain or tightness in the chest Pain or tightness in the chestChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Difficulty sleeping Abnormal breathing pattern (breathing out takes more than twice as long as breathing in)Emergency symptoms that need prompt medical help include:Bluish color to the lips and face (cyanosis) Bluish colorA bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.ImageRead Article Now Book Mark Article Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack Extreme difficulty breathing Difficulty breathingBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Rapid pulse Rapid pulseA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Severe anxiety due to shortness of breath AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Sweating SweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Difficulty speaking Breathing temporarily stops Exams and Tests The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. The provider will take your medical history and ask about your symptoms.Tests that may be ordered include:Allergy testing -- a skin test or a blood test to see if a person with asthma is allergic to certain substances SkinAllergy skin tests are used to find out which substances cause a person to have an allergic reaction. These substances are called allergens....ImageRead Article Now Book Mark Article Blood testAn absolute eosinophil count is a blood test that measures the number of one type of white blood cells called eosinophils. Eosinophils become active...ImageRead Article Now Book Mark Article Arterial blood gas -- often done in people who are having a severe asthma attack Arterial blood gasBlood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.ImageRead Article Now Book Mark Article Chest x-ray or CT scan of the chest -- to check other conditions Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Lung function tests, including peak flow measurements Lung function testsPulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.ImageRead Article Now Book Mark Article Treatment The goals of treatment are to:Control airway swelling Limit exposure to substances that may trigger your symptoms Limit exposure to substances that may t...It is important to know what things make your asthma worse. These are called asthma "triggers. " Avoiding them is your first step toward feeling bet...ImageRead Article Now Book Mark Article Help you to be able to do normal activities without having asthma symptomsYou and your provider should work as a team to manage your asthma symptoms. Follow your provider's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms.MEDICINES FOR ASTHMAThere are two kinds of medicines for treating asthma:Control medicines to help prevent attacks Quick-relief (rescue) medicines for use during attacksLONG-TERM MEDICINESLONG-TERM MEDICINESControl medicines for asthma are medicines you take to control your asthma symptoms. You must use these medicines every day for them to work well. ...ImageRead Article Now Book Mark Article These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take these medicines every day for them to work. Take them even when you feel OK.Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your provider will prescribe the right medicine for you.QUICK-RELIEF MEDICINESQUICK-RELIEF MEDICINESAsthma quick-relief medicines work fast to control asthma symptoms. You take them when you are coughing, wheezing, having trouble breathing, or havi...ImageRead Article Now Book Mark Article These are also called rescue medicines. They are taken:For coughing, wheezing, trouble breathing, or during an asthma attack Just before physical activity to help prevent asthma symptomsTell your provider if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control. Your provider may change the dose or your daily asthma control medicine to reduce the use of quick-relief medicines.Quick-relief medicines include:Short-acting inhaled bronchodilators Oral corticosteroids for a severe asthma attackA severe asthma attack requires a checkup by a provider. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV).ASTHMA CARE AT HOMEYou can take steps to decrease the possibility of asthma attacks:Know the asthma symptoms to watch for. Asthma symptoms to watch forIf you do not know whether or not you have asthma, these 4 symptoms could be signs that you do:Coughing during the day or coughing that may wake you ...Read Article Now Book Mark Article Know how to take your peak flow reading and what it means. Know which triggers make your asthma worse and what to do when it happens. Know which triggersIt is important to know what things make your asthma worse. These are called asthma "triggers. " Avoiding them is your first step toward feeling bet...ImageRead Article Now Book Mark Article Know how to care for your asthma before and during physical activity or exercise.Before and during physical activity or ...Sometimes exercise triggers asthma symptoms. This is called exercise-induced bronchoconstriction (EIB). In the past, this was called exercise-induc...ImageRead Article Now Book Mark Article Asthma action plans are written documents for managing asthma. An asthma action plan should include:Instructions for taking asthma medicines when your condition is stable A list of asthma triggers and how to avoid them How to recognize when your asthma is getting worse, what to do and when to call your providerA peak flow meter is a simple device to measure how quickly you can move air out of your lungs.Peak flow meterChecking your peak flow is one of the best ways to monitor your asthma and to keep it from getting worse. Asthma attacks do not usually come on witho...Read Article Now Book Mark Article It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help let you know when you need to take medicine or other action. Peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack. Numbers below 50% are a sign of a severe attack.Asthma Treatment QuizWhich of the following is not a goal of asthma treatment? A. To cure asthma B. To control airway swelling C. To learn about your asthma triggers so you can avoid them Correct Answer The correct answer is to cure asthma. Unfortunately, there's no way to cure asthma. However, by working closely with your doctor, you can learn to manage it.The main types of medicine for asthma are: A. Medicines that work fast (quick-relief drugs) to ease asthma symptoms B. Medicines that work over time (control drugs) to prevent asthma attacks C. Both A and B Correct Answer The correct answer is both A and B. The goals of asthma treatment are controlling airway swelling and avoiding what triggers your symptoms.This device, used with an inhaler, helps get more medicine into the airways. A. Spacer B. Cap C. Mouthpiece D. Canister Correct Answer The correct answer is spacer. The spacer connects to the mouthpiece. The inhaled medicine goes into the spacer tube first. Then you take two deep breaths to get the medicine into your lungs. Using a spacer wastes less medicine than spraying the medicine into your mouth.Sometimes younger children use a nebulizer to take their medicine. What does this machine do? A. It turns asthma medicine into liquid children can drink B. It turns asthma medicine into a mist children can breathe in Correct Answer The correct answer is it turns asthma medicine into a mist children can breathe in. This device makes it easy and pleasant to breathe in the medicine. Small children may need to use a mask to help them inhale all the mist. Talk with your doctor if you have questions about your child's treatment.You can stop taking your control medicine when you start to feel better. A. True B. False Correct Answer The correct answer is false. Control drugs must be taken every day to be effective. Take your medicine even when you feel OK. You may need to take these medicines for at least a month before you start to feel better. Your doctor will work with you to find asthma medicines that are right for you.Why should you use a peak flow meter to check how quickly you can move air out of your lungs? A. It can tell you if an asthma attack is coming, sometimes before you have symptoms B. It is one of the best ways to control your asthma C. It can help you keep your asthma from getting worse D. All of the above Correct Answer The correct answer is all of the above. Peak flow measurements can help show when you need medicine or other action to treat your asthma. Peak flow values of 50 - 80% of your best results signal a moderate asthma attack, while values below 50% mean a severe attack.If you use quick-relief drugs twice a week or more to control your asthma symptoms, you should: A. Do nothing B. Tell your doctor C. Cut back to once a week Correct Answer The correct answer is tell your doctor. If you need to use quick-relief drugs more than twice a week your asthma may not be under control. Your doctor may need to change your dose of daily control drugs.Getting rid of tobacco smoke at home is the most important thing a family can do to help a child with asthma. A. True B. False Correct Answer The correct answer is true. Don't smoke inside or outside the home. Family members and visitors who smoke outside can carry the smoke inside on their clothes and hair. Helping children avoid asthma triggers is the first step toward helping them feel better.Exercise can bring on asthma symptoms in some people, but you can still participate in the activities you love. Do this ahead of time: A. Use your quick-relief drugs just before exercising B. Drink a glass of water C. Wear a scarf over your mouth Correct Answer The correct answer is use your quick-relief drugs just before exercising. Swimming is a good sport for people with exercise-induced asthma. The warm, moist air helps keep asthma symptoms away. Football, baseball, and other sports with breaks in the action are less likely to trigger asthma symptoms.Asthma action plans should include: A. A plan for taking asthma medicines when your condition is stable B. A list of asthma triggers and how to avoid them C. How to tell when your asthma gets worse, and when to call your doctor or nurse D. All of the above Correct Answer The correct answer is all of the above. An asthma action plan is an important part of treatment for anyone with asthma. If you don't already have one, talk with your doctor about creating a personal asthma action plan.Which of these asthma symptoms is an emergency? A. Bluish lips and face B. Severe drowsiness or confusion during an asthma attack C. Extreme difficulty breathing D. Rapid pulse E. Severe anxiety caused by shortness of breath F. All of the above Correct Answer The correct answer is all of the above. Asthma attacks can be dangerous if a person's airways become severely blocked. If you notice any of these symptoms, call 911. Treatment might include oxygen, breathing assistance, and medicines given through a vein (IV).People with asthma can lead normal, active lives. A. True B. False Correct Answer The correct answer is true. Asthma can be scary, but it doesn't have to control you. By getting the right medical treatment, working closely with your doctor, and avoiding your asthma triggers, you can manage your condition and enjoy a full life. Outlook (Prognosis) There is no cure for asthma, although symptoms sometimes improve over time. With proper self-care and medical treatment, most people with asthma can lead a normal life. Possible Complications The complications of asthma can be severe, and may include:Death Decreased ability to exercise and take part in other activities Lack of sleep due to nighttime symptoms Permanent changes in the function of the lungs Persistent cough Trouble breathing that requires breathing assistance (ventilator) When to Contact a Medical Professional Contact your provider for an appointment if asthma symptoms develop.Contact your provider right away if:An asthma attack requires more medicine than recommended Symptoms get worse or do not improve with treatment You have shortness of breath while talking Your peak flow measurement is 50% to 80% of your personal best Go to the emergency room right away if these symptoms occur:Drowsiness or confusion ConfusionConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Severe shortness of breath at rest A peak flow measurement of less than 50% of your personal best Severe chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Bluish color to the lips and face (cyanosis) Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath Prevention You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways.Cover bedding with allergy-proof casings to reduce exposure to dust mites. Remove carpets from bedrooms and vacuum regularly. Use only unscented detergents and cleaning materials in the home. Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches. Body parts and droppings from cockroaches can trigger asthma attacks in some people. If someone is allergic to an animal that cannot be removed from the home, the animal should be kept out of the bedroom. Place filtering material over the heating/air conditioning outlets in your home to trap animal dander. Change the filter in furnaces and air conditioners often. Eliminate tobacco smoke from the home. This is the single most important thing a family can do to help someone with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair. This can trigger asthma symptoms. If you smoke, now is a good time to quit. Tobacco smokeThings that make your allergies or asthma worse are called triggers. Smoking is a trigger for many people who have asthma.Read Article Now Book Mark Article Avoid air pollution, industrial dust, and irritating fumes as much as possible. Open ReferencesReferencesBoulet L-P, Godbout K. Diagnosis of asthma in adults. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 51.Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF Jr, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update From the National Asthma Education and Prevention Program. JAMA. 2020;324(22):2301-2317. PMID: 33270095 pubmed.ncbi.nlm.nih.gov/33270095/.Liu AH, Spahn JD, Sicherer SH. Childhood asthma. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 169.Marcdante KJ, Kliegman RM, Schuh AM. Asthma. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 78.Vohra TT, Nowak RM. Asthma. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 59.AllVideoImagesTogWhat causes wheezing?Animation Related video goes here for no-HTML5 browsersWhat causes wheezing? - Animation Wheezing can be a normal healthy response to an unhealthy environment. Or, wheezing can be a sign of asthma. I'm Dr. Alan Greene and I want to talk with you for a moment about how to tell the difference, what causes wheezing anyway, and when is it healthy and when is it not. Well to understand that, first let's all take a deep breath together (inhales). When you breathe in, the air comes through your nose or mouth, through the big windpipe and breaks into 2 big bronchi, one into each lung. And from there they break into a whole bunch of little, smaller bronchioles. It's almost like a tree's branches branching out. And those bronchioles are where the wheezing happens. Let's look at a bronchiole. Here's one of those small airways. Now if you happen to walk into a cloud of something that's toxic, your body is going to respond instantly to try to protect you. The first thing that will happen is the muscles around the bronchioles will tighten, will constrict down almost like a boa constrictor, and you get the tight airways. If that toxic cloud is still there, to protect your delicate tissues deep in your lungs, swelling of the lining will happen. Inflammatory stuff to help protect you from those toxins. And if it's still there, still irritating, mucus will begin to be secreted to be able again to capture and protect you from those toxins. That's wheezing. Asthma happens when your airways are hyper-responsive. When they're twitchy. When they're hyper-alert and they respond to something that's not truly dangerous. The problem with that is when your bronchioles are constricted and swollen and has mucus in them, that narrow little opening is hard to breathe through. You have to work to breathe, especially to breath out. And that hard breathing through a narrow passageway is what creates the sound we know as wheezing.Lungs - illustration The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.LungsillustrationSpirometry - illustration Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.SpirometryillustrationAsthma - illustration Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted. The muscles of the bronchial tree become tight and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing sound. This is known as an asthma attack, which can occur as an allergic reaction to an allergen or other substance (acute asthma), or as a part of a complex disease cycle which may include reaction to stress or exercise (chronic asthma).AsthmaillustrationPeak flow meter - illustration A peak flow meter is commonly used by a person with asthma to measue the amount of air that can be expelled from the lungs. If the airways become narrow or blocked due to asthma, peak flow values will drop because the person cannot blow air out of the lungs as well. A peak flow meter can be a useful aid in monitoring a person's asthma over time and can also be used to help determine how well a patient's medications are working.Peak flow meterillustrationAsthmatic bronchiole and normal bronchiole - illustration Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted. When an asthma attack occurs, mucus production is increased, muscles of the bronchial tree become tight, and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing sound. Asthmatic bronchiole and normal bronchioleillustrationCommon asthma triggers - illustration Many of the same substances that trigger allergies can also trigger asthma. Common allergens include pollen, dust mites, mold and pet dander. Other asthma triggers include irritants like smoke, pollution, fumes, cleaning chemicals, and sprays. Asthma symptoms can be substantially reduced by avoiding exposure to known allergens and respiratory irritants.Common asthma triggersillustrationExercise-induced asthma - illustration Exercise-induced asthma is distinct from allergic asthma in that it does not produce long-term increase in airway activity. People who only experience asthma when they exercise may be able to control their symptoms with preventive measures such as warm-up and cool-down exercises.Exercise-induced asthmaillustrationRespiratory system - illustration Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.Respiratory systemillustrationSpacer use - Series - Part onePresentation Metered dose inhaler use - Series - step onePresentation Nebulizer use - Series - Part onePresentation Peak flow meter use - Series - Part onePresentation What causes wheezing?Animation Related video goes here for no-HTML5 browsersWhat causes wheezing? - Animation Wheezing can be a normal healthy response to an unhealthy environment. Or, wheezing can be a sign of asthma. I'm Dr. Alan Greene and I want to talk with you for a moment about how to tell the difference, what causes wheezing anyway, and when is it healthy and when is it not. Well to understand that, first let's all take a deep breath together (inhales). When you breathe in, the air comes through your nose or mouth, through the big windpipe and breaks into 2 big bronchi, one into each lung. And from there they break into a whole bunch of little, smaller bronchioles. It's almost like a tree's branches branching out. And those bronchioles are where the wheezing happens. Let's look at a bronchiole. Here's one of those small airways. Now if you happen to walk into a cloud of something that's toxic, your body is going to respond instantly to try to protect you. The first thing that will happen is the muscles around the bronchioles will tighten, will constrict down almost like a boa constrictor, and you get the tight airways. If that toxic cloud is still there, to protect your delicate tissues deep in your lungs, swelling of the lining will happen. Inflammatory stuff to help protect you from those toxins. And if it's still there, still irritating, mucus will begin to be secreted to be able again to capture and protect you from those toxins. That's wheezing. Asthma happens when your airways are hyper-responsive. When they're twitchy. When they're hyper-alert and they respond to something that's not truly dangerous. The problem with that is when your bronchioles are constricted and swollen and has mucus in them, that narrow little opening is hard to breathe through. You have to work to breathe, especially to breath out. And that hard breathing through a narrow passageway is what creates the sound we know as wheezing.Lungs - illustration The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.LungsillustrationSpirometry - illustration Spirometry is a painless study of air volume and flow rate within the lungs. Spirometry is frequently used to evaluate lung function in people with obstructive or restrictive lung diseases such as asthma or cystic fibrosis.SpirometryillustrationAsthma - illustration Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted. The muscles of the bronchial tree become tight and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing sound. This is known as an asthma attack, which can occur as an allergic reaction to an allergen or other substance (acute asthma), or as a part of a complex disease cycle which may include reaction to stress or exercise (chronic asthma).AsthmaillustrationPeak flow meter - illustration A peak flow meter is commonly used by a person with asthma to measue the amount of air that can be expelled from the lungs. If the airways become narrow or blocked due to asthma, peak flow values will drop because the person cannot blow air out of the lungs as well. A peak flow meter can be a useful aid in monitoring a person's asthma over time and can also be used to help determine how well a patient's medications are working.Peak flow meterillustrationAsthmatic bronchiole and normal bronchiole - illustration Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted. When an asthma attack occurs, mucus production is increased, muscles of the bronchial tree become tight, and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing sound. Asthmatic bronchiole and normal bronchioleillustrationCommon asthma triggers - illustration Many of the same substances that trigger allergies can also trigger asthma. Common allergens include pollen, dust mites, mold and pet dander. Other asthma triggers include irritants like smoke, pollution, fumes, cleaning chemicals, and sprays. Asthma symptoms can be substantially reduced by avoiding exposure to known allergens and respiratory irritants.Common asthma triggersillustrationExercise-induced asthma - illustration Exercise-induced asthma is distinct from allergic asthma in that it does not produce long-term increase in airway activity. People who only experience asthma when they exercise may be able to control their symptoms with preventive measures such as warm-up and cool-down exercises.Exercise-induced asthmaillustrationRespiratory system - illustration Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.Respiratory systemillustration Spacer use - Series - Part onePresentation Metered dose inhaler use - Series - step onePresentation Nebulizer use - Series - Part onePresentation Peak flow meter use - Series - Part onePresentation A Closer Look Asthma(Alt. Medicine)Asthma in adults - InDepth(In-Depth)Asthma in children and adolescents - InDepth(In-Depth)Asthma medications - theophylline derivatives(Alt. Medicine)Talking to your MD Asthma in children - what to ask your doctorAsthma in adults - what to ask the doctorSelf Care Asthma - control drugsAsthma and schoolAsthma - quick-relief drugs Allergies, asthma, and dustAllergies, asthma, and pollen Exercising and asthma at school Stay away from asthma triggersSigns of an asthma attackAllergies, asthma, and moldsExercise-induced asthmaRelated Information Wheezing(Symptoms)Drug allergies(Condition)Allergies(Condition)Atopic dermatitis(Condition)Collapsed lung (pneumothorax)(Condition)Lung plethysmography(Medical Test)Asthma in adults - what to ask the doctor(Doctor Questions)Asthma - control drugs(Self-Care)How to use a nebulizer(Self-Care)Asthma - quick-relief drugs (Self-Care)Asthma and school(Self-Care)Exercise-induced asthma(Self-Care)Exercising and asthma at school (Self-Care)How to use an inhaler - no spacer(Self-Care)How to use an inhaler - with spacer(Self-Care)How to use your peak flow meter(Self-Care)Asthma in adults - InDepth(In-Depth)Asthma in children and adolescents - InDepth(In-Depth)Allergic rhinitis - InDepth(In-Depth) Review Date: 1/22/2023 Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Internal review and update on 02/10/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
AsthmaBronchial asthma; Wheezing - asthma - adultsAsthma is a chronic disease that causes the airways of the lungs to swell and narrow. It leads to breathing difficulty such as wheezing, shortness of breath, chest tightness, and coughing.Related video goes here for no-HTML5 browsers Causes Asthma is caused by swelling (inflammation) in the airways. An asthma attack occurs when the lining of the air passages has become swollen and the muscles surrounding the airways become tight. This narrowing reduces the amount of air that can pass through the airway.Previous imagePlay SlideshowStop SlideshowNext image / Asthma symptoms can be caused by breathing in substances called allergens or triggers, or by other causes.AllergensAn allergen is a substance that can cause an allergic reaction. In some people, the immune system recognizes allergens as foreign or dangerous. As ...ImageRead Article Now Book Mark Article Common asthma triggers include:Animals (pet hair or dander) Dust mites Certain medicines (aspirin and other NSAIDs) Changes in weather (most often cold weather) Chemicals in the air (pollution) or in food Physical activity Mold Pollen Respiratory infections, such as the common cold and many other viruses Common coldThe common cold most often causes a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms....ImageRead Article Now Book Mark Article Strong emotions (stress) Tobacco or other inhalant that is smokedSubstances in some workplaces can also trigger asthma symptoms, leading to occupational asthma. The most common triggers are wood dust, grain dust, animal dander, fungi, or chemicals.Occupational asthmaOccupational asthma is a lung disorder in which substances found in the workplace cause the airways of the lungs to swell and narrow. This leads to ...ImageRead Article Now Book Mark Article Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.AllergiesAn allergy is an immune response or reaction to substances that are usually not harmful.ImageRead Article Now Book Mark Article Allergic rhinitisAllergic rhinitis is a diagnosis associated with a group of symptoms affecting the nose. These symptoms occur when you breathe in something you are ...ImageRead Article Now Book Mark Article EczemaAtopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy rashes. It is a type of eczema. Other forms of eczema include...ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / Symptoms Asthma symptoms vary from person to person. For example, you may have symptoms all the time or mostly during physical activity. Most people with asthma have attacks separated by symptom-free periods. Some people have long-term shortness of breath with episodes of increased shortness of breath. Wheezing or a cough may be the main symptom.Related video goes here for no-HTML5 browsersAsthma attacks can last for minutes to days. An asthma attack may start suddenly or develop slowly over several hours or days. It may become dangerous if airflow is severely blocked.Symptoms of asthma include:Cough with or without sputum (phlegm) production CoughCoughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...ImageRead Article Now Book Mark Article Pulling in of the skin between the ribs when breathing (intercostal retractions) Intercostal retractionsIntercostal retractions occur when the muscles between the ribs pull inward. The movement is most often a sign that the person has a breathing probl...Read Article Now Book Mark Article Shortness of breath that gets worse with exercise or activity Shortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Whistling sound or wheezing as you breathe Pain or tightness in the chest Pain or tightness in the chestChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Difficulty sleeping Abnormal breathing pattern (breathing out takes more than twice as long as breathing in)Emergency symptoms that need prompt medical help include:Bluish color to the lips and face (cyanosis) Bluish colorA bluish color to the skin or mucous membrane is usually due to a lack of oxygen in the blood. The medical term is cyanosis.ImageRead Article Now Book Mark Article Decreased level of alertness, such as severe drowsiness or confusion, during an asthma attack Extreme difficulty breathing Difficulty breathingBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Rapid pulse Rapid pulseA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Severe anxiety due to shortness of breath AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Sweating SweatingSweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...ImageRead Article Now Book Mark Article Difficulty speaking Breathing temporarily stops Exams and Tests The health care provider will use a stethoscope to listen to your lungs. Wheezing or other asthma-related sounds may be heard. The provider will take your medical history and ask about your symptoms.Tests that may be ordered include:Allergy testing -- a skin test or a blood test to see if a person with asthma is allergic to certain substances SkinAllergy skin tests are used to find out which substances cause a person to have an allergic reaction. These substances are called allergens....ImageRead Article Now Book Mark Article Blood testAn absolute eosinophil count is a blood test that measures the number of one type of white blood cells called eosinophils. Eosinophils become active...ImageRead Article Now Book Mark Article Arterial blood gas -- often done in people who are having a severe asthma attack Arterial blood gasBlood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.ImageRead Article Now Book Mark Article Chest x-ray or CT scan of the chest -- to check other conditions Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Lung function tests, including peak flow measurements Lung function testsPulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.ImageRead Article Now Book Mark Article Treatment The goals of treatment are to:Control airway swelling Limit exposure to substances that may trigger your symptoms Limit exposure to substances that may t...It is important to know what things make your asthma worse. These are called asthma "triggers. " Avoiding them is your first step toward feeling bet...ImageRead Article Now Book Mark Article Help you to be able to do normal activities without having asthma symptomsYou and your provider should work as a team to manage your asthma symptoms. Follow your provider's instructions on taking medicines, eliminating asthma triggers, and monitoring symptoms.MEDICINES FOR ASTHMAThere are two kinds of medicines for treating asthma:Control medicines to help prevent attacks Quick-relief (rescue) medicines for use during attacksLONG-TERM MEDICINESLONG-TERM MEDICINESControl medicines for asthma are medicines you take to control your asthma symptoms. You must use these medicines every day for them to work well. ...ImageRead Article Now Book Mark Article These are also called maintenance or control medicines. They are used to prevent symptoms in people with moderate to severe asthma. You must take these medicines every day for them to work. Take them even when you feel OK.Some long-term medicines are breathed in (inhaled), such as steroids and long-acting beta-agonists. Others are taken by mouth (orally). Your provider will prescribe the right medicine for you.QUICK-RELIEF MEDICINESQUICK-RELIEF MEDICINESAsthma quick-relief medicines work fast to control asthma symptoms. You take them when you are coughing, wheezing, having trouble breathing, or havi...ImageRead Article Now Book Mark Article These are also called rescue medicines. They are taken:For coughing, wheezing, trouble breathing, or during an asthma attack Just before physical activity to help prevent asthma symptomsTell your provider if you are using quick-relief medicines twice a week or more. If so, your asthma may not be under control. Your provider may change the dose or your daily asthma control medicine to reduce the use of quick-relief medicines.Quick-relief medicines include:Short-acting inhaled bronchodilators Oral corticosteroids for a severe asthma attackA severe asthma attack requires a checkup by a provider. You may also need a hospital stay. There, you will likely be given oxygen, breathing assistance, and medicines given through a vein (IV).ASTHMA CARE AT HOMEYou can take steps to decrease the possibility of asthma attacks:Know the asthma symptoms to watch for. Asthma symptoms to watch forIf you do not know whether or not you have asthma, these 4 symptoms could be signs that you do:Coughing during the day or coughing that may wake you ...Read Article Now Book Mark Article Know how to take your peak flow reading and what it means. Know which triggers make your asthma worse and what to do when it happens. Know which triggersIt is important to know what things make your asthma worse. These are called asthma "triggers. " Avoiding them is your first step toward feeling bet...ImageRead Article Now Book Mark Article Know how to care for your asthma before and during physical activity or exercise.Before and during physical activity or ...Sometimes exercise triggers asthma symptoms. This is called exercise-induced bronchoconstriction (EIB). In the past, this was called exercise-induc...ImageRead Article Now Book Mark Article Asthma action plans are written documents for managing asthma. An asthma action plan should include:Instructions for taking asthma medicines when your condition is stable A list of asthma triggers and how to avoid them How to recognize when your asthma is getting worse, what to do and when to call your providerA peak flow meter is a simple device to measure how quickly you can move air out of your lungs.Peak flow meterChecking your peak flow is one of the best ways to monitor your asthma and to keep it from getting worse. Asthma attacks do not usually come on witho...Read Article Now Book Mark Article It can help you see if an attack is coming, sometimes even before symptoms appear. Peak flow measurements help let you know when you need to take medicine or other action. Peak flow values of 50% to 80% of your best results are a sign of a moderate asthma attack. Numbers below 50% are a sign of a severe attack.Asthma Treatment QuizWhich of the following is not a goal of asthma treatment? A. To cure asthma B. To control airway swelling C. To learn about your asthma triggers so you can avoid them Correct Answer The correct answer is to cure asthma. Unfortunately, there's no way to cure asthma. However, by working closely with your doctor, you can learn to manage it.The main types of medicine for asthma are: A. Medicines that work fast (quick-relief drugs) to ease asthma symptoms B. Medicines that work over time (control drugs) to prevent asthma attacks C. Both A and B Correct Answer The correct answer is both A and B. The goals of asthma treatment are controlling airway swelling and avoiding what triggers your symptoms.This device, used with an inhaler, helps get more medicine into the airways. A. Spacer B. Cap C. Mouthpiece D. Canister Correct Answer The correct answer is spacer. The spacer connects to the mouthpiece. The inhaled medicine goes into the spacer tube first. Then you take two deep breaths to get the medicine into your lungs. Using a spacer wastes less medicine than spraying the medicine into your mouth.Sometimes younger children use a nebulizer to take their medicine. What does this machine do? A. It turns asthma medicine into liquid children can drink B. It turns asthma medicine into a mist children can breathe in Correct Answer The correct answer is it turns asthma medicine into a mist children can breathe in. This device makes it easy and pleasant to breathe in the medicine. Small children may need to use a mask to help them inhale all the mist. Talk with your doctor if you have questions about your child's treatment.You can stop taking your control medicine when you start to feel better. A. True B. False Correct Answer The correct answer is false. Control drugs must be taken every day to be effective. Take your medicine even when you feel OK. You may need to take these medicines for at least a month before you start to feel better. Your doctor will work with you to find asthma medicines that are right for you.Why should you use a peak flow meter to check how quickly you can move air out of your lungs? A. It can tell you if an asthma attack is coming, sometimes before you have symptoms B. It is one of the best ways to control your asthma C. It can help you keep your asthma from getting worse D. All of the above Correct Answer The correct answer is all of the above. Peak flow measurements can help show when you need medicine or other action to treat your asthma. Peak flow values of 50 - 80% of your best results signal a moderate asthma attack, while values below 50% mean a severe attack.If you use quick-relief drugs twice a week or more to control your asthma symptoms, you should: A. Do nothing B. Tell your doctor C. Cut back to once a week Correct Answer The correct answer is tell your doctor. If you need to use quick-relief drugs more than twice a week your asthma may not be under control. Your doctor may need to change your dose of daily control drugs.Getting rid of tobacco smoke at home is the most important thing a family can do to help a child with asthma. A. True B. False Correct Answer The correct answer is true. Don't smoke inside or outside the home. Family members and visitors who smoke outside can carry the smoke inside on their clothes and hair. Helping children avoid asthma triggers is the first step toward helping them feel better.Exercise can bring on asthma symptoms in some people, but you can still participate in the activities you love. Do this ahead of time: A. Use your quick-relief drugs just before exercising B. Drink a glass of water C. Wear a scarf over your mouth Correct Answer The correct answer is use your quick-relief drugs just before exercising. Swimming is a good sport for people with exercise-induced asthma. The warm, moist air helps keep asthma symptoms away. Football, baseball, and other sports with breaks in the action are less likely to trigger asthma symptoms.Asthma action plans should include: A. A plan for taking asthma medicines when your condition is stable B. A list of asthma triggers and how to avoid them C. How to tell when your asthma gets worse, and when to call your doctor or nurse D. All of the above Correct Answer The correct answer is all of the above. An asthma action plan is an important part of treatment for anyone with asthma. If you don't already have one, talk with your doctor about creating a personal asthma action plan.Which of these asthma symptoms is an emergency? A. Bluish lips and face B. Severe drowsiness or confusion during an asthma attack C. Extreme difficulty breathing D. Rapid pulse E. Severe anxiety caused by shortness of breath F. All of the above Correct Answer The correct answer is all of the above. Asthma attacks can be dangerous if a person's airways become severely blocked. If you notice any of these symptoms, call 911. Treatment might include oxygen, breathing assistance, and medicines given through a vein (IV).People with asthma can lead normal, active lives. A. True B. False Correct Answer The correct answer is true. Asthma can be scary, but it doesn't have to control you. By getting the right medical treatment, working closely with your doctor, and avoiding your asthma triggers, you can manage your condition and enjoy a full life. Outlook (Prognosis) There is no cure for asthma, although symptoms sometimes improve over time. With proper self-care and medical treatment, most people with asthma can lead a normal life. Possible Complications The complications of asthma can be severe, and may include:Death Decreased ability to exercise and take part in other activities Lack of sleep due to nighttime symptoms Permanent changes in the function of the lungs Persistent cough Trouble breathing that requires breathing assistance (ventilator) When to Contact a Medical Professional Contact your provider for an appointment if asthma symptoms develop.Contact your provider right away if:An asthma attack requires more medicine than recommended Symptoms get worse or do not improve with treatment You have shortness of breath while talking Your peak flow measurement is 50% to 80% of your personal best Go to the emergency room right away if these symptoms occur:Drowsiness or confusion ConfusionConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Severe shortness of breath at rest A peak flow measurement of less than 50% of your personal best Severe chest pain Chest painChest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.ImageRead Article Now Book Mark Article Bluish color to the lips and face (cyanosis) Extreme difficulty breathing Rapid pulse Severe anxiety due to shortness of breath Prevention You can reduce asthma symptoms by avoiding triggers and substances that irritate the airways.Cover bedding with allergy-proof casings to reduce exposure to dust mites. Remove carpets from bedrooms and vacuum regularly. Use only unscented detergents and cleaning materials in the home. Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold. Keep the house clean and keep food in containers and out of bedrooms. This helps reduce the possibility of cockroaches. Body parts and droppings from cockroaches can trigger asthma attacks in some people. If someone is allergic to an animal that cannot be removed from the home, the animal should be kept out of the bedroom. Place filtering material over the heating/air conditioning outlets in your home to trap animal dander. Change the filter in furnaces and air conditioners often. Eliminate tobacco smoke from the home. This is the single most important thing a family can do to help someone with asthma. Smoking outside the house is not enough. Family members and visitors who smoke outside carry smoke residue inside on their clothes and hair. This can trigger asthma symptoms. If you smoke, now is a good time to quit. Tobacco smokeThings that make your allergies or asthma worse are called triggers. Smoking is a trigger for many people who have asthma.Read Article Now Book Mark Article Avoid air pollution, industrial dust, and irritating fumes as much as possible. Open ReferencesReferencesBoulet L-P, Godbout K. Diagnosis of asthma in adults. In: Burks AW, Holgate ST, O'Hehir RE, et al, eds. Middleton's Allergy: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 51.Cloutier MM, Dixon AE, Krishnan JA, Lemanske RF Jr, Pace W, Schatz M. Managing Asthma in Adolescents and Adults: 2020 Asthma Guideline Update From the National Asthma Education and Prevention Program. JAMA. 2020;324(22):2301-2317. PMID: 33270095 pubmed.ncbi.nlm.nih.gov/33270095/.Liu AH, Spahn JD, Sicherer SH. Childhood asthma. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 169.Marcdante KJ, Kliegman RM, Schuh AM. Asthma. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 78.Vohra TT, Nowak RM. Asthma. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 59.