Asthma signs and symptoms depend on the severity of the disease. The most common symptoms (patient complains of these) and signs (doctor observes these) include:
wheezing (a high-pitched whistling sound, especially when breathing out),
shortness of breath (dyspnea),
coughing (especially worse at night) and
tightness in the chest.
These symptoms are brought on by narrowing of the airways due to bronchospasm, swelling of the airways, mucous in the airways, and hypersensitivity of the airways to multiple agents including allergens.
These findings are not diagnostic, but the more present the greater the likelihood of asthma. Spirometry is needed to diagnose asthma.
As the severity of the asthma increases these signs and symptoms increase. Severe asthma is characterized by
almost continuous wheezing and coughing
shortness of breath
a marked increase in respiratory rate
tightening and prominent contraction of the neck and chest muscles
When the situation is extreme there is blueness to the skin (cyanosis), panic, inability to fully exhale, and a very characteristic finding of diminished breath sounds with a lack of wheezing (silent chest) which is caused by severe airway obstruction and results in very little movement of air.
The National Asthma Education and Prevention Program (NAEPP) has proposed a classification of asthma based on severity. Physicians who follow this classification can better control their patient’s asthma and provide proper therapy to prevent deterioration or exacerbation of their patient’s asthma. Widespread use of this classification will yield better control of asthma in the United States and throughout the world.