Reviewed by David Tinkelman, MD

Recognizing the signs and symptoms of asthma is important so that treatment and other interventions can begin early. If severe symptoms are present, it is vital to begin the appropriate treatment immediately. Accurate and timely assessment of symptoms can help you and your clinician decide if treatment should begin in the home, at your clinician's office, or in the emergency room.


Early Warning Signs

Early warning signs are experienced before the start of an asthma episode. By recognizing these clues that occur before actual asthma symptoms, early treatment can be started. These signs can be different for each person - and early warning signs may be the same, similar, or entirely different for the same person with each episode. Some early warning signs may be noticed only by the individual, while other early warning signs are more likely to be noticed by other persons. In addition, a downward trend in peak flow numbers can be a reliable early warning sign. Some examples of early warning signs are:

  • Breathing changes

  • Sneezing

  • Moodiness

  • Headache

  • Runny/stuffy nose

  • Coughing

  • Chin or throat itches

  • Feeling tired

  • Dark circles under eyes

  • Trouble sleeping

  • Poor tolerance for exercise

  • Downward trend in peak flow number

Get a complete printable early warning signs of asthma checklist.


Asthma Episode Symptoms

Asthma symptoms indicate that an asthma episode is occurring. Changes have taken place in the airways and airflow is obstructed. Individuals with asthma experience some or all of these during an asthma episode, and action should be taken to treat these symptoms before they become worse. Talk with your healthcare provider about having a written asthma action plan. Examples of asthma symptoms include:

  • Wheezing

  • Coughing

  • Shortness of breath

  • Tightness in the chest

  • Peak flow numbers in the caution or danger range (usually 50% to 80% of personal best)


Severe Asthma Episode Symptoms

Severe asthma symptoms are a life-threatening emergency. If any of these severe asthma symptoms occur, seek emergency medical treatment right away, since these symptoms indicate respiratory distress. Examples of severe asthma symptoms include:

  • Severe coughing, wheezing, shortness of breath, or tightness in the chest

  • Difficulty talking or concentrating

  • Walking causes shortness of breath

  • Breathing may be shallow and fast or slower than usual

  • Hunched shoulders (posturing)

  • Nasal flaring (nostril size increases with breathing)

  • Neck area and between or below the ribs moves inward with breathing (retractions)

  • Gray or bluish tint to skin, beginning around the mouth (cyanosis)

  • Peak flow numbers in the danger zone (usually below 50% of personal best)

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