Early signs of asthma | Diagnosis | Treatment | Early signs of asthma attacks
Asthma is a common condition; it affects more than 339 million people worldwide. It can be so mild that many people don’t even realize they have it. Or, so severe that when uncontrolled, it can cause frightening, potentially deadly, breathing attacks. Fortunately, after asthma is diagnosed, it can be well-controlled. Often early signs of an asthma attack are predictable and an asthma attack can be effectively treated.
5 early signs of asthma
Asthma is a “chronic illness of the lower airways,” says Kunjana Mavunda, MD, pediatric pulmonologist with KIDZ Medical Services. It causes the breathing tubes, or bronchial tubes, in your lungs to narrow or become mucus-filled. If untreated, these symptoms can lead to an asthma attack, an acute episode when the muscles surrounding your airways tighten and your bronchial tubes become swollen—making it hard to breathe. There are two types of warning signs:
- Early asthma symptoms that may make you visit a healthcare provider for a diagnosis
- Early signs of asthma attacks
Knowing both can help you get a diagnosis and avoid dangerous breathing problems.
The main goals of asthma treatment are to control asthma symptoms and reduce the risk of asthma exacerbations, all while minimizing adverse effects of medication.
According to Chet Tharpe, MD, dual-certified allergist and immunologist, and medical director at Curex, symptoms indicating you may have asthma include:
- Prolonged upper respiratory tract infections that persist past the typical 7-10 day course of illness
- Wheezing during viral illness
- Seasonal coughs that seem to last for weeks
- Feeling chest tightness with exertion, like running around
- Stopping or needing to slow down during physical activity
Certain medical conditions might exacerbate asthma or they may confuse symptoms that look like asthma: gastroesophageal reflux (GERD), sinusitis, chronic obstructive pulmonary disease (COPD), or other respiratory illnesses. Having one of these conditions may trigger early signs of asthma.
Can you have asthma without a cough?
Keep in mind that asthma attacks can sometimes happen without warning, which is called silent asthma. “Silent asthma is when asthma symptoms are present, but not recognized,” Dr. Mavunda explains. “These patients may be first diagnosed after they have had an attack.” If you miss subtle early warning signs, an attack may feel like it comes on out of the blue.
Receiving an asthma diagnosis
If you have any signs of asthma, it’s important to seek treatment. To formally diagnose asthma, your healthcare provider will take a medical and family history, complete a physical exam, and run a series of breathing tests. The breathing tests can either be done in the office with a spirometry test, which is a measurement of the volume of air exhaled during a forceful and complete exhalation. Or, you may need pulmonary function tests, which are done in an airtight room and give even more information. Additionally, you may be referred to an allergist to figure out if a specific allergen is triggering symptoms.
Asthma is a complex condition. It is further categorized by the frequency of symptoms:
- Intermittent: Symptoms come and go
- Persistent: You have symptoms most of the time
Then, there are a few specific types of asthma:
- Exercise-induced asthma: Triggered by working out
- Occupational asthma: Occurs when exposed to irritating fumes at work
- Asthma-COPD overlap syndrome (ACOS): A dual diagnosis of asthma and chronic obstructive pulmonary syndrome
There are two main categories of causes:
- Allergic: Allergens trigger an exacerbation of asthma, such as pollen or pet dander
- Non-allergic: External factors make asthma symptoms worse, like weather or stress
Though, scientists don’t know why one person may develop asthma and another may not. “Genetics, environment, and diet may lead to increased symptoms,” Dr. Mavunda says. Established triggers for asthma include:
- Exercise
- Allergens such as dust mites or pollen
- Respiratory infections
- Weather
- Exposure to chemicals, air pollution, or smoke
These are substances or conditions that may bring on an asthma attack for you. They can be different for everyone. Knowing and avoiding triggers can help to prevent asthma attacks, as can diagnosing and treating early symptoms of asthma.
Your provider will rule out other illnesses like pneumonia or a mental health problem, including anxiety. “Asthma and anxiety can both flare with stress and feelings of panic and heart palpitations, so it may not always be easy to distinguish the two,” Dr. Tharpe says.
Dr. Mavunda agrees, “A shortness of breath one feels when they are having an asthma attack may seem like an anxiety attack.” However, an anxiety attack goes away with breathing techniques or anxiety medication while an asthma attack requires an inhaler or other medications.
What age does asthma usually start?
Asthma can occur for the first time at different stages of life:
- Adult-onset: Symptoms first start after your teens
- Pediatric: Typically diagnosed around age 5
Look out for symptoms in young children and toddlers, as asthma is often diagnosed by age 6. “Usually, we say that asthma cannot be diagnosed before the age of 2 years,” Dr. Mavunda says. “However, if an infant has signs of allergies—food, environment, skin, and wheezes frequently, that child may be diagnosed earlier.” Common early signs of asthma in toddlers include coughing while playing or stopping play to rest.
Symptoms can also present later in adolescence—especially when going through puberty. “Hormonal changes may also lead to asthma,” explains Dr. Mavunda. Symptoms may improve during young adulthood, then reappear later in life. “Women who had asthma when younger, and whose asthma may have been controlled without medications for many years, may restart with symptoms in their 40s,” Dr. Mavunda says.
In other words, asthma affects adults, too. Don’t ignore new asthma symptoms as it can reappear at any time.
Learning to treat asthma
Asthma is treatable. “The goal of asthma management is to have the least number of symptoms, and a good quality of life with proper control of the environment, avoiding irritants, both edible as well as inhaled and the correct use of proper medications that cause the least amount of side effects,” Dr. Mavunda says.
An albuterol inhaler is the first step in treating asthma. However, this may not be enough for more severe asthma. If you need albuterol more than twice a week, you most likely need asthma medications, such as:
- A nebulizer treatment
- Steroid inhalers, such as Qvar
- Oral steroids, like prednisone
- Monoclonal antibodies injection, like Nucala
- Preventive oral medication, such as Singulair
Your healthcare provider will help you find the treatment regimen that works best for you. Keeping an eye out for early signs and managing them quickly is the key to living a full, healthy life with asthma.
12 early signs of an asthma attack
Even if you’re on asthma medications, you need a rescue inhaler because it functions to rescue you. Carry your rescue inhaler on you at all times and prepare for these early symptoms of an asthma attack:
- Scratchy or sore throat
- Fatigue
- Headache
- Sleeping poorly
- Exercise intolerance
- Frequent coughing, especially at night
- Chest and/or neck tightness
- Wheezing
- Feelings of anxiety and panic
- Pale, sweaty face
- Rapid breathing
- Blue lips or fingertips
These symptoms can occur in combination, or separately. You might have certain symptoms before one asthma attack and different symptoms before another.
If your inhalers are not working and you continue to feel short of breath, you need to get emergent care and may need to call 911. Breathing is essential to live.
