What if inhaler therapy does not relieve chest tightness?

Chest tightness can persist when the inhaler is not reaching the lungs because of technique, when the prescribed medicine does not match the current flare, or when infection, allergy or another condition is contributing. A preventer inhaler is used regularly and is not the same as a reliever inhaler for sudden symptoms. Do not change doses or combine inhalers unless instructed.

Notice wheeze, cough, fever, breathlessness, chest pain, palpitations and the timing of symptoms. Tightness after exercise or exposure to smoke, dust or a known allergen may also help a clinician understand the pattern.

Use the inhaler exactly as prescribed and check the device technique with a pharmacist or clinician. If you have a written asthma or breathing action plan, follow its instructions. Sit upright, move away from smoke or other triggers, and avoid strenuous activity while symptoms continue.

Arrange a prompt review when symptoms keep returning, wake you at night, limit normal activity or require more reliever medicine than directed. Bring every inhaler and spacer to the appointment so the device, dose and technique can be checked together.

Call emergency services if you are struggling to speak in full sentences, breathing is rapidly worsening, your lips look blue or grey, you feel faint or confused, or the prescribed reliever is not helping according to your action plan. Treat severe chest pressure, sweating, nausea or pain spreading to the arm, jaw or back as an emergency rather than assuming it is asthma.

Is my inhaler technique correct, and should I use a spacer? Am I using a preventer and reliever appropriately? Could infection, allergy, reflux or a heart problem explain the tightness? What exact signs mean I should call emergency services?