Symptoms of an asthma attack vary from person to person and depend upon the nature and severity of the reaction. Signs and symptoms often associated with asthma attacks include:

• Wheezing (a whistling or high-pitched sound that results when breathing tubes are narrowed or obstructed)
  
• Shortness of breath
• Chest tightness or pain
• Coughing (with or without mucus)
• Difficulty speaking
• Extreme fatigue

An acute asthma attack is a sudden reaction to an allergen or an upper respiratory infection such as a cold. Such asthma attacks are potentially fatal because they often do not respond to quick-relief medications such as inhaled bronchodilators.

These severe attacks are known as “status asthmaticus.” Symptoms include:

• Persistent coughing, or – conversely – absence of coughing and wheezing. The latter is a very dangerous condition sometimes called “silent chest.” It indicates that the bronchial tubes (large air passageways which bring oxygen to the lungs and remove carbon dioxide from the body during breathing) are too clogged to allow those symptoms to manifest.
  
  
• Inability to speak full sentences or to walk without feeling shortness of breath
  
  
• Bluish tint to lips (cyanosis)
  
  
• Tight chest
  
  
• Sucking in of the skin between the ribs when breathing (occurs most often in children)
  
  
• Agitation, confusion and inability to concentrate

Such symptoms are a warning of impending respiratory failure. Patients who experience a sudden attack that does not resolve despite inhaler use should immediately head to the emergency room. A medical ventilator may be necessary to keep the lungs and respiratory muscles functioning and prevent death.