Left untreated, an asthma attack can cause additional damage. The alveoli (air sacs at the end of air passageways in the lungs) may rupture, causing air to gather in the space between the membrane layers that cover the lungs (pleural space) or allowing air to collect around the organs in the chest. This exacerbates shortness of breath. If left to progress, an asthma attack can turn fatal.

Occasionally, a second attack can occur about four hours after the initial exposure to the allergen or irritant that triggered the initial attack.  Secondary attacks may occur when changes develop in the patient’s air tubes. The lungs can become more sensitive to irritants after an initial asthma attack, leading to another attack. Symptoms of this reaction can last for several hours or even weeks after the first attack. Additional recurrent attacks can also follow, often at night.

An asthma attack involves only the bronchial tubes (large air passageways which bring oxygen to the lungs and remove carbon dioxide from the body during breathing). The air sacs and lung tissue are not affected by asthma. As these bronchial tubes repeatedly become inflamed with each new asthma attack, the walls can become permanently thickened in a process known as airway remodeling. This is dangerous because it makes the bronchioles (small air passageways within the lungs) less responsive to medications designed to keep the airways open.