Wheezing, shortness of breath, cough, and chest tightness are the main symptoms of asthma.
Asthma symptoms develop when the lining of the bronchial tubes swells and becomes inflamed, the muscles around the airways tighten, and the airways produce an overabundance of mucus.
These changes narrow the passage of the airways, making it difficult to breathe.
The most common symptoms of asthma include:
- Wheezing (a whistling or squeaky, almost musical-like sound during breathing)
- Shortness of breath (feeling like you can't get enough air into your lungs)
- Cough, which may contain phlegm and is generally worse at night or early in the morning
- Chest tightness, pain, or pressure, or feeling like something is squeezing or sitting on your chest
Not everyone with asthma experiences symptoms the same way, and asthma symptoms can differ between attacks.
Severe Asthma Attack Symptoms
Asthma attacks vary in severity. During severe attacks, which require immediatemedical attention, you may experience:
- Extreme difficulty breathing
- Very rapid breathing, with the skin pulling in between the ribs and chest plate during inhalation
- Cyanosis (a bluish color to the lips, face, and fingernails)
- Anxiety or panic
- Uncontrollable coughing
- Severe wheezing
- Sweating
- Rapid nostril movement
- Inflated chest, even after exhaling
Asthma Diagnosis
Your doctor will diagnose asthma based on your medical and family history, a physical exam, lung function tests, and other tests.
Part of this process is asking a series of questions to find out whether you have any of the telltale signs of asthma and to try to understand the causes of your symptoms.
You will need to describe your symptoms, their severity, and their frequency, and discuss factors that may be associated with your symptoms. These may include:
- Exposure to allergens, including pet dander (skin flakes), pollen, cockroaches, and household dust mites
- Exposure to airborne irritants, such as cigarette smoke, smog, and industrial pollution
- Use of medicines
- Lifestyle and exercise habits
- Work-related exposures
- Illnesses (including colds) and their associated symptoms
Your doctor will also ask you about your family history of asthma, allergies, and eczema.
If it appears that you may have asthma, your doctor will conduct a physical exam that includes inspection of your ears, eyes, nose, throat, and skin, and will use a stethoscope to listen to your lungs.
Lung Function Tests
Lung function tests, which measure your breathing, can confirm suspected asthma.
Spirometry is the standard test to diagnose asthma. In this simple breathing test, you breathe into a mouthpiece connected to a device called a spirometer.
This device measures the amount of air you're able to exhale and inhale, as well as how fast you can blow the air out.
These measurements convey information about the narrowing of your bronchial tubes.
Another lung function test, called peak airflow, involves breathing into a peak flow meter. This small, handheld device measures the maximal force of air you can blow out.
Peak flow testing can also be done with a spirometer.
You can use a peak flow meter at home, which may help you determine whether your condition is getting better or worse over time.
Nitric oxide tests can help determine how much inflammation is occurring in your lungs. Your body normally produces nitric oxide, and research has shown this gas to be an indicator of inflammation.
For this test, you exhale into a small, handheld machine for 10 seconds at a steady pace. The machine will calculate the amount of nitric oxide in your breath.
Other Asthma Tests
Your doctor may recommend a number of other tests to further understand your condition and to rule out other causes of your symptoms. These tests include:
- Inhalation challenge tests, which measure your physical reaction to breathing in methacholine or mannitol(known asthma triggers)
- Imaging tests, such as chest X-rays and computerized tomography (CT) scans of your lungs and sinuses, to look for signs of infection or other abnormalities
- Allergy tests
- Tests to determine whether you have another condition with asthma-like symptoms, such as gastroesophageal reflux disease (GERD), chronic sinus disease, vocal cord dysfunction, or sleep apnea
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