Table of ContentsView AllTable of ContentsWhy Asthma Attacks May Be FatalSevere AsthmaWho’s at Risk?Warning SignsComplicationsManagementWhen to Seek Emergency Help
Table of ContentsView All
View All
Table of Contents
Why Asthma Attacks May Be Fatal
Severe Asthma
Who’s at Risk?
Warning Signs
Complications
Management
When to Seek Emergency Help
Asthma is a serious medical condition that causes inflammation and constriction of the airways. If left untreated, it can affect your quality of life. A severe asthma attack can sometimes be fatal.
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Asthma isinflammationand constriction of thebronchial tubes, the passages that allow air to enter and exit the lungs.Anasthma attackoccurs when the muscles around the bronchial tubes constrict, narrowing the airways and making breathing difficult.
How long an asthma attack lasts can vary from person to person. A mild attack may only last a few minutes, whereas a severe one can last for hours or days with on-and-off symptoms.The length of the asthma attack will depend on how severe the inflammation is and how well you respond to treatment. Without treatment, the attack may continue, worsen, and even become fatal.
Impaired breathing can lead to a fatal asthma attack. A severe attack can make it harder to get enough air into the lungs. The lack of air may stop your breathing, and the lack of oxygen can damage the brain and body.
Managing Asthma Flare-Ups
More than 25 million Americans are living with asthma, and up to 10% of people with asthma have severe asthma that does not respond to typical asthma treatments.This group will typically need care from anasthma specialistto find the right treatment plan.
There is no universal definition of severe asthma. However, the World Health Organization (WHO) categorizes severe asthma in three ways:
Your healthcare provider will rely on the number of attacks you have, the need for inhaled therapy or oral corticosteroids, and respiratory function to determine your asthma’s severity.Even with these measures, severity can vary from person to person. Further, a severe attack for one person may present differently than it would for someone else.
Why some people develop severe asthma and why others do not is unknown.Even so, anyone can experience a severe asthma attack.
Possible causes of severe attacks include:
Who’s at Risk of a Fatal Attack?
According to the Centers for Disease Control and Prevention (CDC), there were 3,517 asthma deaths in the United States in 2021.However, deaths due to asthma are rare, and effective treatment can prevent premature death related to an asthma attack.
According to the CDC, adults are six times more likely than children to die from an asthma attack.The death rate is higher for people 65 and older compared to other age groups. People assigned female at birth, non-Hispanic Blacks, and boys are at a higher risk for asthma-related death in comparison to other groups.
Additional risk groups include:
Cost of Asthma Care in People of Color
The symptoms of a severe asthma attack present similarly to a mild attack. However, these symptoms will be more intense and more challenging to manage with asthma medications. They can also be life-threatening.
Symptoms may include:
Some potential warning signs of an oncoming severe asthma attack are:
Is Asthma Fatal During Sleep?
Some people with asthma have symptoms that worsen at night. This is a condition called nocturnal asthma. A severe nighttime attack can lead to symptoms like wheezing, chest tightness, coughing, and trouble breathing.
A severe attack can occur at any time during the night. If you are having an attack, you can wake up to asthma symptoms.
If you are having frequent nighttime symptoms, this is a sign your asthma is not controlled. Nocturnal asthma can interrupt sleep patterns, cause daytime fatigue, and make daytime functioning harder. Severe nighttime attacks can also be life-threatening if not properly managed.
Secondary Complications and Hospitalization
People with severe asthma have a higher risk of asthma-related complications and hospitalizations.
Complications linked to severe asthma include lifestyle disruptions and medical complications. Lifestyle complications include those related to sleep and physical activity.
Sleep disruptions can occur in people who experience asthma symptoms at night, and the lack of sleep could affect your ability to function at school and work.It may also make driving and operating heavy machinery dangerous.
Asthma can also affect your ability to be physically active.Inactivity may lead to weight gain and increase the risk of chronic diseases like diabetes and high blood pressure.
Severe and uncontrolled asthma could also mean increased time in the hospital or emergency department and more medical appointments, which could cause you to miss work, school, or other activities.
Asthma is a long-term condition that requires ongoing treatment to minimize complications. Sometimes, asthma medications come with side effects like rapid heartbeat, throat irritation, hoarseness,oral yeast infections, andgastroesophageal reflux disease (GERD).
Untreated or severe asthma can cause chronic inflammation of the airways, which can lead to loss of lung function, chronic cough, thickening of airways, lung infections, and increased mucus and blood supply in the airways.
Severe asthma can also cause psychological side effects, such as depression and anxiety.
An asthma attack forces the lungs to work extra hard to get enough air, which can affect breathing. It may also put pressure on the heart and cause it to stop working.Chronic inflammation of the airways over time can lead to blood vessel damage or plaque buildup in the arteries, which can lead to heart attack or stroke.
Quality of Life
Despite the potential for asthma-related complications, with effective treatment, you can live a long and good quality life.
Hospitalizations
According to the American Lung Association, there were 94,560 asthma-related hospitalizations in 2020.Fortunately, hospitalization rates have been decreasing in recent decades, although they increased during theCOVID-19 pandemic.
An acute severe attack could require a four- to six-day hospital stay.To be discharged from the hospital, you would need to demonstrate a decreased need for a rescue albuterol, walking without shortness of breath, and the ability to sleep all night without new or worsening symptoms. Some people who experience a severe attack may need a breathing tube to pump oxygen into their lungs.
You may need to go to the hospital if you are having an asthma attack that causes:
What Are the Symptoms of Severe Asthma
Comorbidities and HospitalizationComorbidities are coexisting conditions that develop independently of each other.Although they may share risk factors, they do not directly cause each other. However, one condition can contribute to the worsening of another.Asthma comorbidities can increase your risk for a severe attack that requires hospitalization. Comorbid conditions linked to asthma include allergies, anxiety, obesity, respiratory diseases, diabetes, and cardiovascular disease.Many of these conditions can worsen a person’s asthma. They need treatment and management so they do not contribute to severe attacks or lead to hospitalizations.
Comorbidities and Hospitalization
Comorbidities are coexisting conditions that develop independently of each other.Although they may share risk factors, they do not directly cause each other. However, one condition can contribute to the worsening of another.Asthma comorbidities can increase your risk for a severe attack that requires hospitalization. Comorbid conditions linked to asthma include allergies, anxiety, obesity, respiratory diseases, diabetes, and cardiovascular disease.Many of these conditions can worsen a person’s asthma. They need treatment and management so they do not contribute to severe attacks or lead to hospitalizations.
Comorbidities are coexisting conditions that develop independently of each other.Although they may share risk factors, they do not directly cause each other. However, one condition can contribute to the worsening of another.
Asthma comorbidities can increase your risk for a severe attack that requires hospitalization. Comorbid conditions linked to asthma include allergies, anxiety, obesity, respiratory diseases, diabetes, and cardiovascular disease.
Many of these conditions can worsen a person’s asthma. They need treatment and management so they do not contribute to severe attacks or lead to hospitalizations.
How to Manage Severe Asthma
You can manage severe asthma with medication, lifestyle therapies, and avoiding triggers.
Medications
Biologicsare another option for treating moderate to severe asthma.These treatments target specific parts of the inflammation response involved in asthma.
Additional treatments for severe asthma include:
The Best Medicine for Asthma
Lifestyle Therapies
Lifestyle interventions have been found to be helpful tools for people with asthma.They are easily accessible, low-cost therapies that have minimal side effects. They are used in addition to medication.
Such interventions include:
Reducing Triggers
Asthma triggersare factors that make asthma symptoms worse.When you encounter a trigger, you may experience an asthma attack.
Common asthma triggers respiratory illnesses, allergens (substances that may provoke an allergic response), irritants, exercise, and stress. Knowing what causes asthma symptoms can help control them.
Allergy testingmight help identify triggers. Your healthcare provider can also help you recognize asthma symptoms and ways to reduce and avoid triggers.
How Colds and Asthma Are Linked
Because severe asthma attacks can be life-threatening, knowing when to seek emergency medical care is crucial.
If you experience shortness of breath or chest tightness that quickly gets worse, call 911 or have someone get you to the hospital quickly. You should also seek medical treatment if a quick-relief inhaler does not help to manage the symptoms of an asthma attack.
Treatment at the hospital may include:
After your initial treatment, hospital personnel will monitor you to ensure the treatment has helped. They will also decide whether you will need to stay in the hospital overnight or longer for additional treatment and monitoring.
Summary
Though dying from an asthma attack is rare, it is possible. Most asthma-related deaths are due to a lack of treatment or uncontrolled symptoms. Quick treatment for a severe asthma attack can save a person’s life and reduce their risk for complications and hospitalizations.
If you find that treatments are not keeping your symptoms managed, let your healthcare provider know. You should seek out emergency medical care for a severe asthma attack.
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27 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Most recent national asthma data.American College of Allergy, Asthma, & Immunology.Asthma attack.American Lung Association.Severe asthma.Alves AM, Marques de Mello L, Lima Matos AS, Cruz ÁA.Severe asthma: comparison of different classifications of severity and control.Respir Med. 2019;156:1-7. doi:10.1016/j.rmed.2019.07.015Bagnasco D, Paggiaro P, Latorre M, et al.Severe asthma: one disease and multiple definitions.World Allergy Organ J. 2021;14(11):100606. doi:10.1016/j.waojou.2021.100606University of Rochester Medical Center.Acute severe asthma.Centers for Disease Control and Prevention.The status of asthma in the United States.Centers for Disease Control and Prevention.Asthma as the underlying cause of death.Vianello A, Caminati M, Crivellaro M, et al.Fatal asthma; is it still an epidemic?World Allergy Organ J. 2016;9(1):42. doi:10.1186/s40413-016-0129-9Sleep Foundation.What is nocturnal asthma?Luyster FS, Shi X, Baniak LM, et al.Associations of sleep duration with patient-reported outcomes and health care use in US adults with asthma.Ann Allergy Asthma Immunol. 2020;125(3):319-324. doi:10.1016/j.anai.2020.04.035Panagiotou M, Koulouris NG, Rovina N.Physical activity: a missing link in asthma care.J Clin Med. 2020;9(3):706. doi:10.3390/jcm9030706Kostakou E, Kaniaris E, Filiou E, et al.Acute severe asthma in adolescent and adult patients: current perspectives on assessment and management.J Clin Med. 2019;8(9):1283. doi:10.3390/jcm8091283Massachusetts General Hospital.How to manage side effects of asthma medications.Gillissen A, Paparoupa M.Inflammation and infections in asthma.Clin Respir J. 2015;9(3):257-269. doi:10.1111/crj.12135Caulfield JI.Anxiety, depression, and asthma: new perspectives and approaches for psychoneuroimmunology research.Brain Behav Immun Health. 2021;18:100360. doi:10.1016/j.bbih.2021.100360American Lung Association.How are asthma and heart health linked?Kharaba Z, Feghali E, El Husseini F, et al.An assessment of quality of life in patients with asthma through physical, emotional, social, and occupational aspects. a cross-sectional study.Front Public Health. 2022;10:883784. doi:10.3389/fpubh.2022.883784American Lung Association.Asthma trends brief: asthma trends and burden.Duong TN, Zeki AA, Louie S.Medical management of hospitalized patients with asthma or chronic obstructive pulmonary disease.Hosp Med Clin. 2017;6(4):437-455. doi:10.1016/j.ehmc.2017.05.002Brown R, Thorsteinsson E.Comorbidity: What is it and Why is it important?In: Brown R, Thorsteinsson E. (eds) Comorbidity. Palgrave Macmillan, Cham. (2020).Mahdavian M, Power BH, Asghari S, Pike JC.Effects of comorbidities on asthma hospitalization and mortality rates: a systematic review.Can Respir J. 2018;2018:6460379. doi:10.1155/2018/6460379Narasimhan K.Difficult-to-treat and severe asthma: management strategies.Am Fam Physician.2021;103(5):286-290.Lee Y, Lee JH, Park SY, et al.Roles of real-world evidence in severe asthma treatment: challenges and opportunities.ERJ Open Res. 2023;9(2):00248-2022. doi:10.1183/23120541.00248-2022Stoodley I, Williams L, Thompson C, et al.Evidence for lifestyle interventions in asthma.Breathe (Sheff). 2019;15(2):e50-e61. doi:10.1183/20734735.0019-2019American Lung Association.Reduce asthma triggers.Al-Shamrani A, Al-Harbi AS, Bagais K, et al.Management of asthma exacerbation in the emergency departments.Int J Pediatr Adolesc Med. 2019;6(2):61-67. doi:10.1016/j.ijpam.2019.02.001
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Most recent national asthma data.American College of Allergy, Asthma, & Immunology.Asthma attack.American Lung Association.Severe asthma.Alves AM, Marques de Mello L, Lima Matos AS, Cruz ÁA.Severe asthma: comparison of different classifications of severity and control.Respir Med. 2019;156:1-7. doi:10.1016/j.rmed.2019.07.015Bagnasco D, Paggiaro P, Latorre M, et al.Severe asthma: one disease and multiple definitions.World Allergy Organ J. 2021;14(11):100606. doi:10.1016/j.waojou.2021.100606University of Rochester Medical Center.Acute severe asthma.Centers for Disease Control and Prevention.The status of asthma in the United States.Centers for Disease Control and Prevention.Asthma as the underlying cause of death.Vianello A, Caminati M, Crivellaro M, et al.Fatal asthma; is it still an epidemic?World Allergy Organ J. 2016;9(1):42. doi:10.1186/s40413-016-0129-9Sleep Foundation.What is nocturnal asthma?Luyster FS, Shi X, Baniak LM, et al.Associations of sleep duration with patient-reported outcomes and health care use in US adults with asthma.Ann Allergy Asthma Immunol. 2020;125(3):319-324. doi:10.1016/j.anai.2020.04.035Panagiotou M, Koulouris NG, Rovina N.Physical activity: a missing link in asthma care.J Clin Med. 2020;9(3):706. doi:10.3390/jcm9030706Kostakou E, Kaniaris E, Filiou E, et al.Acute severe asthma in adolescent and adult patients: current perspectives on assessment and management.J Clin Med. 2019;8(9):1283. doi:10.3390/jcm8091283Massachusetts General Hospital.How to manage side effects of asthma medications.Gillissen A, Paparoupa M.Inflammation and infections in asthma.Clin Respir J. 2015;9(3):257-269. doi:10.1111/crj.12135Caulfield JI.Anxiety, depression, and asthma: new perspectives and approaches for psychoneuroimmunology research.Brain Behav Immun Health. 2021;18:100360. doi:10.1016/j.bbih.2021.100360American Lung Association.How are asthma and heart health linked?Kharaba Z, Feghali E, El Husseini F, et al.An assessment of quality of life in patients with asthma through physical, emotional, social, and occupational aspects. a cross-sectional study.Front Public Health. 2022;10:883784. doi:10.3389/fpubh.2022.883784American Lung Association.Asthma trends brief: asthma trends and burden.Duong TN, Zeki AA, Louie S.Medical management of hospitalized patients with asthma or chronic obstructive pulmonary disease.Hosp Med Clin. 2017;6(4):437-455. doi:10.1016/j.ehmc.2017.05.002Brown R, Thorsteinsson E.Comorbidity: What is it and Why is it important?In: Brown R, Thorsteinsson E. (eds) Comorbidity. Palgrave Macmillan, Cham. (2020).Mahdavian M, Power BH, Asghari S, Pike JC.Effects of comorbidities on asthma hospitalization and mortality rates: a systematic review.Can Respir J. 2018;2018:6460379. doi:10.1155/2018/6460379Narasimhan K.Difficult-to-treat and severe asthma: management strategies.Am Fam Physician.2021;103(5):286-290.Lee Y, Lee JH, Park SY, et al.Roles of real-world evidence in severe asthma treatment: challenges and opportunities.ERJ Open Res. 2023;9(2):00248-2022. doi:10.1183/23120541.00248-2022Stoodley I, Williams L, Thompson C, et al.Evidence for lifestyle interventions in asthma.Breathe (Sheff). 2019;15(2):e50-e61. doi:10.1183/20734735.0019-2019American Lung Association.Reduce asthma triggers.Al-Shamrani A, Al-Harbi AS, Bagais K, et al.Management of asthma exacerbation in the emergency departments.Int J Pediatr Adolesc Med. 2019;6(2):61-67. doi:10.1016/j.ijpam.2019.02.001
Centers for Disease Control and Prevention.Most recent national asthma data.
American College of Allergy, Asthma, & Immunology.Asthma attack.
American Lung Association.Severe asthma.
Alves AM, Marques de Mello L, Lima Matos AS, Cruz ÁA.Severe asthma: comparison of different classifications of severity and control.Respir Med. 2019;156:1-7. doi:10.1016/j.rmed.2019.07.015
Bagnasco D, Paggiaro P, Latorre M, et al.Severe asthma: one disease and multiple definitions.World Allergy Organ J. 2021;14(11):100606. doi:10.1016/j.waojou.2021.100606
University of Rochester Medical Center.Acute severe asthma.
Centers for Disease Control and Prevention.The status of asthma in the United States.
Centers for Disease Control and Prevention.Asthma as the underlying cause of death.
Vianello A, Caminati M, Crivellaro M, et al.Fatal asthma; is it still an epidemic?World Allergy Organ J. 2016;9(1):42. doi:10.1186/s40413-016-0129-9
Sleep Foundation.What is nocturnal asthma?
Luyster FS, Shi X, Baniak LM, et al.Associations of sleep duration with patient-reported outcomes and health care use in US adults with asthma.Ann Allergy Asthma Immunol. 2020;125(3):319-324. doi:10.1016/j.anai.2020.04.035
Panagiotou M, Koulouris NG, Rovina N.Physical activity: a missing link in asthma care.J Clin Med. 2020;9(3):706. doi:10.3390/jcm9030706
Kostakou E, Kaniaris E, Filiou E, et al.Acute severe asthma in adolescent and adult patients: current perspectives on assessment and management.J Clin Med. 2019;8(9):1283. doi:10.3390/jcm8091283
Massachusetts General Hospital.How to manage side effects of asthma medications.
Gillissen A, Paparoupa M.Inflammation and infections in asthma.Clin Respir J. 2015;9(3):257-269. doi:10.1111/crj.12135
Caulfield JI.Anxiety, depression, and asthma: new perspectives and approaches for psychoneuroimmunology research.Brain Behav Immun Health. 2021;18:100360. doi:10.1016/j.bbih.2021.100360
American Lung Association.How are asthma and heart health linked?
Kharaba Z, Feghali E, El Husseini F, et al.An assessment of quality of life in patients with asthma through physical, emotional, social, and occupational aspects. a cross-sectional study.Front Public Health. 2022;10:883784. doi:10.3389/fpubh.2022.883784
American Lung Association.Asthma trends brief: asthma trends and burden.
Duong TN, Zeki AA, Louie S.Medical management of hospitalized patients with asthma or chronic obstructive pulmonary disease.Hosp Med Clin. 2017;6(4):437-455. doi:10.1016/j.ehmc.2017.05.002
Brown R, Thorsteinsson E.Comorbidity: What is it and Why is it important?In: Brown R, Thorsteinsson E. (eds) Comorbidity. Palgrave Macmillan, Cham. (2020).
Mahdavian M, Power BH, Asghari S, Pike JC.Effects of comorbidities on asthma hospitalization and mortality rates: a systematic review.Can Respir J. 2018;2018:6460379. doi:10.1155/2018/6460379
Narasimhan K.Difficult-to-treat and severe asthma: management strategies.Am Fam Physician.2021;103(5):286-290.
Lee Y, Lee JH, Park SY, et al.Roles of real-world evidence in severe asthma treatment: challenges and opportunities.ERJ Open Res. 2023;9(2):00248-2022. doi:10.1183/23120541.00248-2022
Stoodley I, Williams L, Thompson C, et al.Evidence for lifestyle interventions in asthma.Breathe (Sheff). 2019;15(2):e50-e61. doi:10.1183/20734735.0019-2019
American Lung Association.Reduce asthma triggers.
Al-Shamrani A, Al-Harbi AS, Bagais K, et al.Management of asthma exacerbation in the emergency departments.Int J Pediatr Adolesc Med. 2019;6(2):61-67. doi:10.1016/j.ijpam.2019.02.001
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