Symptoms
Asthma symptoms vary in severity from occasional mild bouts of breathlessness to daily wheezing that persists despite taking large doses of medication. After exposure to asthma triggers, symptoms rarely develop abruptly but progress over a period of hours or days. In some cases, the airways have become seriously obstructed by the time the patient even calls the doctor.
The classic symptoms of an asthma attack are the following:
- Wheezing when breathing out is nearly always present during an attack. Usually the attack begins with wheezing and rapid breathing, and, as it becomes more severe, all breathing muscles become visibly active.
- Shortness of breath (dyspnea). Shortness of breath is a major source of distress in asthma patients. It should be noted, however, that the severity of this symptom does not always reflect the degree to which lung function is impaired. In fact, according to one study, a quarter of patients are not aware that they are experiencing shortness of breath (referred to as "a blunted perception of dyspnea"). Such patients are at particular risk for very serious and even life-threatening asthma attacks, since they are less conscious of symptoms. Those at highest risk for this effect tend to be older, female, and to have the disease for a longer period of time.
- Coughing. In some people the first symptom of asthma is a nonproductive cough. In fact, in a 2001 survey, 12% of asthma patients reported coughing as a significant problem. Patients surveyed tended to feel that daytime cough was even more distressing than wheezing or sleep disturbances.
- Chest tightness or pain. Initial chest tightness without any other symptoms may be an early indicator of a serious attack.
- The neck muscles may tighten, and talking may become difficult or impossible.
- Rapid heart rate.
- Sweating.
- Chest pain occurs in about three-quarters of patients. It can be very severe, although its intensity is not necessarily related to the severity of the asthma attack itself.
The end of an attack is often marked by a cough that produces a thick, stringy mucus. After an initial acute attack, inflammation persists for days to weeks, often without symptoms. (The inflammation itself must still be treated, however, because it usually causes relapse.)
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