According to the Asthma and Allergy Foundation of America, “Approximately 25 million people in the U.S. have asthma. This equals about 1 in 13 people.” Despite its prevalence, asthma remains manageable but not curable. Its severity and symptoms are varied; and its triggers are many. Often the first question asthma sufferers and their family members ask is: “What is an asthma attack?”

Asthma is a chronic condition in which an overly sensitive immune system causes the patient’s conducting airways to become obstructed in response to certain triggers. In an asthma attack, or asthma exacerbation, the muscles around the airways tighten suddenly in what is called a bronchospasm. The linings of airways swell and thicken – anywhere from 10 to 100 percent. Finally, higher-than-normal amounts of thick mucus form, even further obstructing airways.

Those three conditions lead to the wheezing, coughing, rapid breathing and chest tightness that asthma sufferers know all too well. In severe attacks, patients can have a pale face, blue lips or fingernails and difficulty talking. Anxiety or even panic can also be seen. The Centers for Disease Control and Prevention estimates that in a single year more than 2 million emergency room visits are attributable to asthma and that more than 3,000 die from it.

Want to know what it’s like to experience an asthma attack? The University of Illinois Hospital & Health Sciences System offers these two simulations:

• Run in place for a minute or two, until you can feel your heart start to beat fast. Take a plastic drinking straw and put it in your mouth. Hold your nose closed and continue to breathe through the straw.
• Take a deep breath in and hold it a moment. Now let out about a tenth of the air in your lungs. Breathe back in. Breathe out that same small amount of air. Breathe back in. Repeat until you can’t stand it anymore.

Treatment and testing

The most commonly seen asthma treatment is the use of rescue medications taken for rapid, short-term relief from symptoms. These can include short-acting beta agonists such as albuterol, Ipratropium (Atrovent), and oral or intravenous corticosteroids for serious attacks. Long-term asthma control medications are taken regularly to help prevent attacks. They include inhaled corticosteroids, Leukotriene modifiers, long-acting beta agonists, Theophylline, and combination inhalers that contain a corticosteroid and a long-acting beta agonist.

Just as asthma symptoms vary from person to person, so too do the triggers of attacks. Common triggers include exercise, pollutants such as tobacco smoke, upper respiratory infections, gastroesophageal reflux disease, even inhaling cold, dry air. Airborne allegens are another common cause.

Medication and management

The diagnosis of asthma is by a thorough review of the patient’s individual and family medical history, physical examination and pulmonary function testing. If airborne allergens are suspected triggers, allergy skin testing can also be performed.