During an asthma attack, the patient experiences shortness of breath and difficulty in breathing, particularly in breathing out. This is due to the narrowing of the airways in the lungs. The walls of the bronchioles contract and the linings of the airways swell. At the same time, excess mucus is produced. These reactions cause all the classic symptoms of asthma — shortness of breath, wheezing and coughing. Very little fresh air enters the lungs during an asthma attack, and the air that does enter is distributed very unevenly.

An asthma attack can be a very frightening experience for all concerned. Any attack not quickly relieved by medication should be regarded as serious. Some attacks become so severe that breathing is nearly impossible.

During severe attacks, air entry into the alveoli is reduced, carbon dioxide builds up and the oxygen level drops. This alteration of the blood gases can result in cyanosis, a bluish discolouration of the skin resulting from inadequate oxygenation of the blood. When cyanosis develops, the patient's neck muscles often bulge with the effort to breath. At this stage, an asthmatic can collapse and die unless medical treatment is administered immediately.

While only a very small percentage of asthmatics actually die during an attack, no one with asthma should take any attack lightly. Unfortunately, severe asthma can strike susceptible people anytime — the only solution is to always be prepared.