Can be chronic to acute, mild to severe. Acute attack often occur at night. During an acute attack, audible inspiratory and expiratory wheezing. Patient appears to be in acute respiratory distress. Tachypnea, use of accessory muscles for breathing, nasal flaring, apprehensive, sweating. If treatment is successful, the attack ends with continue up of large quantities of thick tenacious sputum, repeated attack may continue in case of infection.
Persons with severe asthatic attack that are difficult to control with usual medications may be developing status asthmaticus. In this condition, air trapping in the distal airspace leads to respiratory muscle exhaustion and severe ventilation-perfusion abnormalities with resultant respiratory failure and hypoxemia.
Patient with status asthmaticus is unable to talk due to severe respiratory distress, becomes cyanosed and changed sensorium.
This is a medical emergency.