Symptoms and Diagnosis

Your asthma symptoms may be mild, moderate, or severe.To find out if you have asthma, your doctor may examine you, ask questions about your health, or order tests, including a breathing test.

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Asthma Symptoms

When you have asthma, you may:

  • Wheeze, making a loud or soft whistling noise when you breathe in and out. This happens when the airways of the lungs narrow.
  • Cough a lot. This is the only symptom for some people.
  • Feel tightness in your chest.
  • Feel short of breath. You may have rapid, shallow breathing, or trouble breathing.
  • Have trouble sleeping because you're coughing or having a hard time breathing.
  • Get tired quickly during exercise.

Symptoms of asthma can be mild or severe. You may have symptoms every day or just now and then, or you may have something in between. Sometimes your symptoms may suddenly get worse (or flare up) and cause an asthma attack.

Some people have symptoms that get worse at night, such as a cough and shortness of breath.

How asthma affects your breathing

When you have asthma, you may have trouble breathing. Your symptoms may be mild, moderate, or severe. If you are having trouble breathing, follow your asthma action plan.

Symptoms of mild trouble breathing:

  • Breathing slightly faster than normal
  • Normal skin color

Symptoms of moderate trouble breathing:

  • Obviously breathing faster than normal.
  • Tiring quickly when you talk or eat. You may have to catch your breath during eating. Having trouble breathing when you eat may lead to poor nutrition.
  • Using your belly muscles to help you breathe. Your belly wall collapses inward instead of expanding outward when you breathe in.
  • Skin color that is pale to slightly gray, or lacy purple and pale (mottled). But your tongue, gums, and lips remain pink.

Symptoms of severe trouble breathing:

  • Breathing very fast. Children usually grunt with each breath. When you're short of breath, it can make it hard to speak smoothly.
  • Appearing anxious and being unable to eat because it's too hard to breathe.
  • Using your neck, chest, and belly muscles to breathe. The skin between, above, and under the ribs collapses inward with each breath. You also may open your nostrils wide when you breathe in.
  • Taking longer than usual to breathe out and sometimes having a high-pitched, musical sound when you breathe in.
  • Sitting up, leaning forward, or sitting with your nose tilted up as if sniffing the air.
  • Skin color that is persistently pale, gray, bluish, or mottled, including the tongue, lips, earlobes, and nail beds.

Dealing with an asthma attack: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe trouble breathing.

Call your doctor now or seek immediate medical care if:

  • Your symptoms do not get better after you have followed your asthma action plan.
  • You have new or worse trouble breathing.
  • Your coughing and wheezing get worse.
  • You cough up dark brown or bloody mucus (sputum).
  • You have a new or higher fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You need to use quick-relief medicine on more than two days a week (unless it is just for exercise).
  • You cough more deeply or more often, especially if you notice more mucus or a change in the color of your mucus.
  • You are not getting better as expected.

Dealing with an asthma attack in children: When to call

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child has severe trouble breathing.

Call your doctor now or seek immediate medical care if:

  • Your child’s symptoms do not get better after you’ve followed his or her asthma action plan.
  • Your child has new or worse trouble breathing.
  • Your child’s coughing or wheezing gets worse.
  • Your child coughs up dark brown or bloody mucus (sputum).
  • Your child has a new or higher fever.

Watch closely for changes in your child’s health, and be sure to contact your doctor if:

  • Your child needs quick-relief medicine on more than two days a week (unless it is just for exercise).
  • Your child coughs more deeply or more often, especially if you notice more mucus or a change in the color of the mucus.
  • Your child is not getting better as expected.

Asthma Diagnosis

To find out if you have asthma, your doctor will do a physical exam and ask you questions about your health.

Your doctor may also have you do breathing (lung function) tests to find out how well your lungs work. He or she may also do other tests to make sure your symptoms aren't caused by another lung or health problem.

Breathing (lung function) tests

Lung function tests can help your doctor diagnose asthma, see how bad it is, and check for problems. These tests may include:

  • Spirometry. Doctors use this test to diagnose and keep track of asthma. It measures how quickly you can move air in and out of your lungs and how much air you move.
  • Peak expiratory flow. This test shows how much air you can breathe out when you try your hardest. Testing of daytime changes in your peak flow may be done over one to two weeks. This test may help when you have symptoms off and on but your spirometry test results are normal.
  • An exercise or inhalation challenge. This test measures how well you can breathe in and out after exercise or after taking a medicine. It may be used if the spirometry test results have been normal or near normal but asthma is still suspected. This test also may be done using a specific irritant or allergen if your doctor thinks you may have occupational asthma.

Tests for other diseases

Asthma can be hard to diagnose because the symptoms vary widely. And asthma-like symptoms can also be caused by other conditions, such as a viral lung infection (like pneumonia), a vocal cord problem, or a problem with another organ, like your heart. So your doctor may want to do other tests.

  • More lung function tests may be needed if your doctor suspects another lung disease, such as chronic obstructive pulmonary disease (COPD).
  • An electrocardiogram (EKG or ECG) might be done to rule out serious conditions with similar symptoms, such as chronic heart failure. This test measures the electrical signals that control the rhythm of your heartbeat.
  • A bronchoscopy test can be done to examine the airways for problems such as tumors or foreign bodies. This test uses a long, thin, lighted tube to look at your airways.
  • Biopsies of the airways can be done to look for changes that point to asthma.
  • A chest X-ray may be used to look for signs of other lung diseases, such as fibrous tissue caused by chronic inflammation (pulmonary fibrosis).
  • Blood tests, such as a complete blood count (CBC), may be done to look for signs of an infection or other condition.

If your doctor thinks your symptoms may be caused by allergies, he or she may order allergy tests.


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©2019 Healthwise, Incorporated. This information does not replace the advice of a doctor.

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Symptoms & Diagnosis

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Complications

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Treatment

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