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What are the Steps of an Asthma Attack?

Three major steps in an asthma attack

There are three major steps in an asthma attack. First, you have constriction. Bronchoconstriction is the medical term for the narrowing of the airways that occurs in an asthma attack. The bronchioles, or tubes that allow air to flow in and out of the lungs, are surrounded by a type of muscle called smooth muscle. The second is inflammation and the third is mucus production.

Bronchial inflammation and excess mucus production

It has been known for a long time that acute inflammation of the bronchial tubes occurs during asthma attacks. The bronchial tubes become swollen and narrowed and mucus is secreted into the tubes from glands in the walls of the tubes. Swelling of the tubes and their plugging with mucus make it difficult to breathe. You may cough up some of this thick, gooey mucus during a flare of your asthma. Increased mucus production is a common sign of inflammatory airway diseases such as asthma and COPD. In these conditions, excess mucus production is likely to be responsible for acute flare ups and a feature of chronic symptoms. In COPD, the overpopulation of mucus cells in the small airways may be the cause of patient's distress, while reports of mucus plugging and thickening are typical in autopsies of asthma patients.

What happens during an asthma attack?

Bronchial inflammation and excess mucus production prevent the necessary amount of oxygen to enter the lungs and when that happens, patients experience certain symptoms such as shortness of breath, tightness in their chests, lightheadedness, and ultimately are unable to breathe. Asthmatics often begin to panic and feel overcome with anxiety due to their inability to breathe. During an asthma attack, the muscles that surround the bronchial tubes constrict, narrowing the air passages and making it extremely difficult to breathe. Other common symptoms are wheezing and a rattling sound in the chest.

Variations in asthma attacks 

The duration of an asthma attack can vary, depending on what caused it and how long the airways have been inflamed. Mild episodes may last only a few minutes and more severe ones can last from hours to days. Mild attacks can resolve spontaneously or may require medication, typically a quick-acting inhaler. More severe asthma attacks can be shortened with appropriate treatment. Gradually, your lungs may tighten so much during an asthma attack that there is not enough air movement to produce wheezing. This is sometimes called the "silent chest", and it is a dangerous sign which may require further medical attention.


If you do not receive adequate treatment for an asthma attack, you may eventually be unable to speak and can develop a bluish coloring around your lips. This color change, known as "cyanosis", means you have less and less oxygen in your blood. Without immediate aggressive treatment in an emergency room or intensive care unit, you may lose consciousness and eventually die.

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