Symptoms:

In children with asthmatic symptoms, it is important to first consider as a possible cause inhaled foreign objects such as peanuts; viral infections such as croup; and bacterial infections, which may be accompanied by high fever and progress rapidly. Any child who has frequent coughing or respiratory infections should be checked for asthma.

Typical Asthma Symptoms

The classic symptoms of an asthma attack include:

• Wheezing is nearly always present during an attack.
• Shortness of breath (dyspnea). Shortness of breath is a major source of distress in patients with asthma.
• Coughing. In some people, the first symptom of asthma is a nonproductive cough. The cough may be worse at night.
• Chest tightness or pain. Initial chest tightness without any other symptoms may be an early indicator of a serious attack.
• Rapid heart rate
• Sweating

Any of these symptoms may worsen with exercise, viral infections, exposure to irritants, stress, or changes in weather.

The end of an attack is often marked by a cough that produces thick, stringy mucus. After an initial acute attack, inflammation persists for days to weeks, often without symptoms. (The inflammation itself must still be treated, however, because it usually causes relapse.)

Symptoms of a Life-Threatening Attack

The following signs and symptoms may indicate a life-threatening situation:

• As the chest labors to bring enough air into the lungs, breathing often becomes shallow.
• Lacking enough oxygen, the skin becomes bluish.
• The flesh around the ribs of the chest appears to be sucked in.
• The patient may begin to lose consciousness.

Asthma often progresses very slowly to a serious condition, but at times a fatal or near-fatal attack may develop within a few minutes. It is very difficult to predict when an attack will become very serious.

Exercise-Induced Asthma (EIA)

Exercise-induced asthma (EIA) is a limited form of asthma in which exercise triggers coughing, wheezing, or shortness of breath. This condition generally occurs in children and young adults, most often during intense exercise in cold dry air. Symptoms are generally most intense about 10 minutes after exercising, then gradually resolve.

EIA is triggered only by exercise and is distinct from ordinary allergic asthma in that it does not produce a long duration of airway activity, as allergic asthma does. (However, some people have both forms of asthma.) People who have only EIA do not appear to need long-term maintenance therapy.

Nocturnal Asthma

Asthma occurs primarily at night (nocturnal asthma) in as many as 75% of patients with asthma. Attacks often occur between 2 and 4 a.m. Some doctors believe that nocturnal asthma may actually be a unique form, with its own specific biologic mechanisms occurring only at night.