Asthma and shortness of breath: what to notice

Asthma-related breathlessness may come with wheeze, cough or chest tightness and may follow exercise, cold air, smoke, infection or allergen exposure. Heart, blood and other lung problems can produce a similar sensation.

Variable episodes that improve with the reliever steps in a personal asthma plan can fit asthma. Breathlessness that is constant, appears for the first time, occurs with palpitations or swelling, or feels different from previous asthma episodes warrants clinical review rather than self-diagnosis.

A clinician may consider asthma control alongside infection, anaemia, an irregular heart rhythm and other airway or heart conditions. The timing, triggers, associated symptoms, examination and breathing tests help distinguish these possibilities.

Stop the activity, sit upright and follow your written asthma action plan. Use prescribed reliever medicine exactly as directed, stay away from smoke or a known trigger, and have someone remain with you if symptoms are significant.

After a flare settles, arrange follow-up if it was more intense than usual or if episodes are becoming frequent. Note what you were doing, how quickly symptoms developed, accompanying chest discomfort and how well the reliever worked.

Seek emergency help now for severe or rapidly worsening breathlessness, inability to speak in full sentences, blue or grey lips, confusion, collapse, or little improvement after following the emergency part of your asthma plan.

Sudden breathing difficulty with facial or tongue swelling, hives or faintness can accompany anaphylaxis. Breathlessness with crushing or spreading chest pressure, sweating or nausea also needs immediate emergency assessment.

Ask whether your symptom pattern fits controlled asthma, whether inhaler technique or preventer treatment needs review, and whether breathing or blood tests are appropriate. Clarify your personal thresholds for urgent action and what to do if reliever medicine has little effect.