What Is Going on in the Lung during an Asthma Attack?

Asthma attack
Bronchoconstriction & Asthma Attack. Photo © A.D.A.M.

Question: What Is Going on in the Lung during an Asthma Attack?

Understanding what happens in your body during an asthma attack may help you understand how and why your doctor provides certain treatments or asks you to avoid certain things.

Answer:

Asthma attacks are common and have a tremendous societal impact:

  • Asthma leads to nearly 2 million emergency room visits each year.
  • Worsening asthma symptoms result in 14 million doctor visits and 439,000 hospital stays.
  • An asthma hospital stay lasts on average more than 3.5 days and is the third leading cause of hospitalization in children.
  • African-Americans are three times more likely to be hospitalized from asthma compared to patients of other races.

An asthma attack is any acute change in your asthma symptoms that interrupts your normal routine and requires either extra medication or some other intervention to improve so that you can breathe normally again. When your asthma worsens, three primary changes take place in your lungs that make your airways smaller:

  • Increased Mucus: As your airways become irritated and inflamed, the cells produce more mucus. The thick mucus may clog up the airways of your ling.
  • Inflammation and Swelling: Just as your ankle swells from the irritation caused by a twisted ankle, the airways of your lung swell in response to whatever is causing your asthma attack.
  • Muscle Tightening: As the smooth muscles in your airways tighten in response to your asthma attack, the airways become smaller.

    The narrowing of the airways may occur and bring on symptoms very quickly, or it may occur over a longer period of time. The symptoms of the attack itself may range from very mild to very severe.

    These symptoms include:

    Asthma attacks may occur when you have an infection like the common cold or some other kind of viral or bacterial respiratory infection.

    Likewise, your symptoms may worsen when you breathe in something that irritates your lungs, such as cigarette smoke, dust or other possible triggers.

    It is important to know how to handle an asthma attack when it occurs. This is especially important as only 1 in 3 asthma deaths occur in the hospital. This indicates that you need to be on top of your asthma symptoms and know what to do when they occur as well as when you need to seek out more emergent treatment. All of this information should be part of the asthma action plan that you periodically review with your asthma doctor. If you do not have a plan you need to ask your doctor for one. If you have one, but do not understand how to implement it, you need to make an appointment to review it with you doctor. Not being able to implement your plan is almost no different than having one.

    Sources:

    American Lung Association. Accessed May 16, 2016. What is asthma?

    Asthma and Allergy Foundation of America. Accessed March 16, 2016. Asthma Facts and Figures

    Asthma. In Chest Medicine: Essentials Of Pulmonary And Critical Care Medicine. Editors: Ronald B. George, Richard W. Light, Richard A. Matthay, Michael A. Matthay. May 2005, 5th edition.

    National Heart, Lung, and Blood Institute. Accessed: May 16, 2016 Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

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