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What is an Asthma Attack?

Emma Lloyd
Emma Lloyd

Asthma is a chronic respiratory condition in which inflammatory airway constriction reduces the flow of air to the lungs, causing shortness of breath, wheezing and coughing. An asthma attack is a physiological process that occurs when a person with asthma comes into contact with a triggering substance. During an asthma attack, a chain of events is triggered, leading to airway constriction and breathing difficulty. People with asthma typically use medication to reduce the frequency and severity of attacks, and they use additional medication during attacks to prevent airways from becoming dangerously constricted.

Globally, asthma is the most common chronic disease of childhood. It is a common chronic disease across all age groups. An estimated 2 percent to 10 percent of the population is affected in industrialized nations. Worldwide, approximately 300 million people have the disease.

An asthma inhaler.
An asthma inhaler.

Several types of cells of the immune system, including mast cells, macrophages, neutrophils and eosinophils, play a role in the pathophysiology of asthma. These cells are involved in mediating acute and chronic inflammatory reactions, and they are central to the development of asthma and the inflammation that occurs during an asthma attack. Many substances can trigger an attack, including dust, pollen, mold, smoke, animal hair, animal dander and chemical fumes.

Cigarette smoke can trigger an asthma attack.
Cigarette smoke can trigger an asthma attack.

When someone with asthma comes into contact with a trigger substance, his or her immune system is triggered to mount a reaction that is virtually immediate. This reaction is an asthma attack, during which the immune reaction to the trigger substance causes the airways to swell and become narrower. Several immune cell types secrete pro-inflammatory substances, and the airway muscles begin to contract strongly, causing greater constriction. At the same time, airway cells begin producing excess mucus, which further narrows the airways and causes congestion. All of these events serve to constrict and congest the airways and make breathing difficult.

An illustration of the pathology of asthma.
An illustration of the pathology of asthma.

The goals of asthma treatment are to reduce the frequency of attacks and reduce the severity of attacks that do occur. This is achieved with medications such as anti-inflammatories and bronchodilators. Anti-inflammatory medications help reduce chronic symptoms of asthma, such as coughing and wheezing, by reducing inflammation. During an asthma attack, bronchodilators are used to widen the airways and make breathing easier.

An inhaler delivers medication to a patient's airways.
An inhaler delivers medication to a patient's airways.

Many people with asthma find that attacks are more frequent in the mornings or evenings. In addition, someone with asthma is at greater risk of an attack if he or she has a respiratory infection. The frequency of attacks can be reduced by avoiding known trigger substances. In particular, avoiding cigarette smoke is an important preventative measure for children with asthma.

Discussion Comments

anon1001640

Candyquilt, I believe that asthma attacks can only be brought on by a triggering substance, for examplem pollen. If you are going to look at stress as a factor for an asthma attack, I would lean in the direction of anxiety more so than asthma.

serenesurface

@discographer-- I agree with this. Moreover, asthma is partly genetic. Maybe someone who is under stress may experience the feeling that it's difficult to breathe. But a true asthma attack has a trigger and the individual probably has a genetic inclination.

My dad has asthma for example, and I got it from him. Although people can have asthma attacks without being chronic asthma sufferers due to respiratory infections, it's usually a genetic and long-term problem. It may not be cured but it can be controlled. As long as an asthma sufferer knows what to do when an attack starts, it will be fine. It's a good idea for family and close friends of asthma sufferers to know what to do in the event of an attack too. My husband knows where I keep my extra bronchodilator at home in case he has to fetch it for me during an attack and administer it.

discographer

@candyquilt-- That's an interesting question. I don't really have an answer for you. I have asthma and I actually don't think that stress alone can trigger an asthma attack. Like you said, there has to be some other physical trigger. The person must be exposed to something they are sensitive or allergic too.

What might be possible is that stress may increase sensitivity to these allergens and increase the likelihood of attacks. Perhaps this was the point of the article that you read. It is mostly accepted now that stress affects the immune system negatively and may make a person more susceptible to disease. I'm sure the same could be said for allergic responses and asthma.

candyquilt

What about psychological asthma attacks? I read that stress and worrying can be a trigger of asthma attacks for some people. But how is this possible? Doesn't asthma attack occur after some kind of irritating substance enters the airways and triggers an inflammatory response? How can that kind of inflammatory response happen when there is no substance, just stress? Can anyone explain this?

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    • An asthma inhaler.
      By: alctxphoto
      An asthma inhaler.
    • Cigarette smoke can trigger an asthma attack.
      By: Николай Григорьев
      Cigarette smoke can trigger an asthma attack.
    • An illustration of the pathology of asthma.
      By: Alila
      An illustration of the pathology of asthma.
    • An inhaler delivers medication to a patient's airways.
      By: perfectmatch
      An inhaler delivers medication to a patient's airways.
    • All inhalers must be prescribed by a physician.
      By: Sergey Zvyagintsev
      All inhalers must be prescribed by a physician.
    • Proper exercise can strengthen the lungs and help decrease the severity and frequency of asthma attacks.
      By: Photographee.eu
      Proper exercise can strengthen the lungs and help decrease the severity and frequency of asthma attacks.
    • It is not uncommon for asthma sufferers to also fall victim to certain allergies.
      By: robyelo357
      It is not uncommon for asthma sufferers to also fall victim to certain allergies.
    • A nebulizer mask can help a person experiencing a severe asthma attack.
      By: bnmk0819
      A nebulizer mask can help a person experiencing a severe asthma attack.
    • A person with asthma is at greater risk of an attack if she or he has a respiratory infection.
      By: vbaleha
      A person with asthma is at greater risk of an attack if she or he has a respiratory infection.