Chest Pain and Asthma Attacks: Signs and Response
Last updated: April 2022
Chest pain, or chest pressure, is a common symptom felt prior to, during, and after asthma attacks. So why do asthmatics experience such chest discomfort, what does it mean, and what can you do about it?
Disclaimer. Chest pain is kind of a generic symptom, and can refer to anything from a tickling or burning sensation or actual pressure, tightness, or pain in your chest. It can be caused by asthma, allergies, anxiety, gastrointestinal reflux, and it can also be cardiac related. According to the Mayo Clinic, If you experience unexplained chest pain lasting more than two minutes, it is better to seek medical help than to try to figure out the cause on your own.
Chest pain prior to asthma attacks
When this happens, it is considered an early warning sign of asthma. It means an asthma attack is imminent if you don't take action right away.
Here I would like to use myself as an example. I have a severe allergy to dust mites. I take Advair 500 to make my airways less sensitive to them. Still, even this is not enough to prevent my airways from getting twitchy when I’m exposed to dust mites.
As a kid, back in the 1980s, I collected baseball cards. Freshly removed from packs, they smelled like bazooka bubble gum. I spent many hours sorting them, or admiring them. This was something I could do, even when the asthma was acting up.
Fast forward 30 years, and they smell like old, musty cardboard. When I sort through them for any length of time the chest pressure begins. Why does this happen? Its' because dust mite feces gets into the air I inhale, and my immune system recognizes it as harmful, and initiates a full out onslaught.
This causes worsening airway inflammation, resulting in a tickling feeling in my chest. So, dust mite exposure causes airway twitchiness resulting in airway itchiness. This can become chest tightness, and even shortness of breath, if I don't take action.
What is the treatment for this? The treatment is to follow your asthma action plan. My plan calls for me simply to remove myself from whatever is causing the symptoms, in this case the baseball cards. If needed I can use my rescue inhaler. If needed I can take a benadryl. In most cases, my chest pressure gradually dissipates simply by finding something else to do.
Chest pain as a sign of acute asthma
So, say I don’t pull myself away from those cards. In fact, let’s give another example. I have a lot of boxes in my basement. So, say I decide to go through those boxes in order to clean out the basement. Lord knows this has happened before. I become passionate about the project. I am finding some old things I haven’t seen in 30 years. I am having a lot of fun.
Now, I notice the tickling, then the chest pressure, but I do not pull myself away. I continue sorting things out. I find a pile of old pay stubs and decide to see how much I made back in 1988 (it was $1.25).
So now it’s been over an hour, and my chest is tight. I ignore this. After a while, my chin starts to itch (another common early warning symptom of asthma for me). I am rapt in the project and having fun, so I delay and delay and delay. I want to get the project done. Then the anxiety/panic hits. This is when I start to break things or rip important papers, such as the cover of my yearbook from Madison Elementary in 1976. When this happens is the cue that I cleaned too long, and must finish the project later, or let someone else do it.
As I get up to go upstairs, I realize that I am in a full-fledged allergy and asthma attack. My chest pain is scorching, but so too is the itchy chin, itchy face, itchy scalp, and shortness of breath. I might also be sneezing, have itchy eyes, etc. I am now able to only take in about a half of breath at a time. My shoulders are hunched, and I’m using accessory muscles to breathe. Yes, now I realize I should have heeded the early warning symptoms and signs of asthma. But now it’s too late.
What is the treatment for this? The treatment, again, is following your asthma action plan. For me, this entails getting away from the dust mites, treating myself with albuterol, and probably taking a benadryl. Then I wait until my breath comes back, which it usually does in an hour or so.
Chest pain after an asthma attack
So it’s 24 hours later. My breathing is normal, but my chest is sore and stiff. This is normal after an asthma attack, especially if it was bad enough that your accessory muscles were utilized to help yo inhale. They hurt because they normally aren't used, and when they are used small muscles fibers on these muscles are torn, causing pain and stiffness the next day.
This is no different than the pain and soreness you feel after a good, strong workout, the kind of workout you do to make your muscles bigger and stronger. Of course, in our case, we don’t want our accessory muscles getting bigger and stronger. Still, because I used them yesterday, they hurt today.
What is the treatment for this? As with the pain and soreness due to any other workout, this pain and soreness will go away in a day or two. If you want to take a Tylenol or something that is up to you and your doctor to determine. As for me, I just wait it out. Actually, as for me, I don’t let myself get this bad anymore. Of course, if you are as familiar with this thing we call asthma as I am, sometimes it happens even when we don’t plan on it. So that’s why we take our daily asthma controller medicines, have asthma action plans, and avoid our asthma triggers the best we can.>
Bottom line. Chest pain, however you want to describe it, is a common early warning sign of asthma. While it may cause discomfort, pain is actually a good thing: it's your body saying that you should heed the warning and take action. Sore, stiff muscles the day after an attack is normal and usually goes away in a day or two. If you continue to have concerns about any chest discomfort you feel, don't hesitate to seek medical consultation.
So, I shared my experience with asthma-related chest pain. For me, it is a common early warning sign. Every asthmatic is different. So, do you ever experience it? Let us know in the comments below?
How often do you find time to focus on yourself?
Join the conversation