Can you have a asthma attack but with good sats and no wheezing?

Hi am 25 and only just been diagnose 2 mouth ago. In the last month I been on steroids and antibiotics twice and been taken to A&E twice.

I get taken to hospital with a server coughing fit that last from a hour plus the time i been taken in I have been have a no stop coughing fit for 2 hours and by this time am very tried in pain and finding it hard to take breath inbetween the coughing and aslo get dizzy cold and very shaky with then. I find the doctors look at me like am mad because my sats are fine me chest X-ray is clear but you can see how hard am finding it to control my breathing. In the end they but me on a nebuliser which stop the coughing with in 5 min. When i was back to normal they started asking if i smoke etc which i dont they ask if i have panic attack they said they think is a on set of my asthma but they dont no what causeing it as i dont have the normal asthma sign so when it happend come back.

Iam just wonding if anyone has every had this and can this be a asthma attack or have my GP got it wrong and it something else?

Please help thank you

12 Replies

  • Absolutely! I rarely have an audible wheeze when I have asthma attacks, even severe ones. And my sats rarely drop unless it takes hours for them to get things under control. Unfortunately instead of a gradual drop, they tend to stay okay, and then plummet... There is a huge range of presentations, everyone is different.

    I hope you are feeling better soon.

    Lynda :)

  • to me the fact that the nebuliser helps rapidly suggests that it is asthma, there is such a thing as CVA (cough variant asthma) where the only symptom is coughing, people with this can have clear sounding chests but that doesn't stop it being an asthma attack. It may be sensible if you are continuing to have attacks to rule out other options that could cause a cough but no wheeze, and you can discuss these with your GP. are you on preventer treatments? i only ask as sometimes if you've only been recently diagnosed then you can just have a blue inhaler, if you are having attacks and requiring oral steroids then it might be worth going back to your doc to discuss stepping up your regular medication (usually this means either adding a steroid inhaler or a long acting reliever if you already have a steroid inhaler)

    with regards to oxygen sats and chest xrays. i usually have a clear chest xray (they often describe it as clear when you have hyperinflation which is a sign of an asthma attack - they just dont really tend to mention it if its obvious to them you are having an asthma attack, you could always ask if your xrays show this) i think cxrays look for either infection which could be triggering an asthma attack - but are certainly not the only cause, or things that arent asthma attacks like clots and stuff (i may be wrong about this!). i also have very good oxygen saturations, i can usually hold them up at around 98% especially if i am given a nebuliser with oxygen, until im really tired, but they have never dropped significantly. I do however get high co2 levels which they cant measure with a sats probe, instead they do whats called an ABG (arterial blood gas) where they take some blood from your wrist and this measures o2, co2, ph and a load of other stuff. High co2 levels are a sign of a severe attack from my understanding, and i know other people on here ave had to be intubated despite having good oxygen levels. from my understanding, a young, generally healthy person can often hold their o2 sats until they are very tired but its a case of when they start to fall the person gets ill very quickly. My consultant told me this when i was arguing that i should be discharged as my oxygen was so good, he just said that he would be really panicing if my o2 was low, and that i'd almost certainly be in intensive care. the fact that you have good oxygen saturtions doesnt mean that you arent struggling or that its not an asthma attack.

    I would go back to your GP, and it may be worth considering if there is an alternative diagnosis, but if nebulisers do help you then to me that would suggest asthma is likely. do you ever get 'classic' asthma symptoms, the wheezing, shortness of breath? nighttime coughing? that kind of stuff? that would make an asthma diagnosis more likely, but as i say, there are plenty of asthmatics who never wheeze. and i know that i am quite unwell when i do start to wheeze, and people have said my chest sounds really good and i have ended up in resus that same day. It also sounds like it might be worth stepping up your treatment to help stop you having these attacks. hope your feeling better soon!

  • Hi Soph Yes am on both steroid inhaler and long acting reliever. I have come across CVA before when i been looking it up myself and it does sound like it. Yes i do have the Wheezing mostly at night or when I first woke up and also have the chest pain and tightness. I have got a appiment with my asthma nurse tomorrow so iam going ask if there other cause instead of just asthma. Am so glad am not the only one that has great sats but clearly finding it hard to breath put me mind at ease so much thank you for all your replays xx

  • good that youre on both, if theyve only been recently started then maybe they aren't fully in your system yet - if not maybe worth a higher dose? there are plenty of things you can try, im sure you can discuss it much better with the nurse, good luck and let us know what she says :-)

  • Hi Laurajayne

    Yep that me high sats cough like mad and they think that its panic well its not, surley being medical professionals they should know better!! lol. Anyway i have only wheezed once in a bad attack but even then my sats were 97/98% oh and guess what my chest was clear, but i knew somthing was wrong as my PF was 300 i am normally anything 390 -450 without ventolin etc on a good day.

    Like yourself after 5 mins on a neb guess what the attack eases up

    good luck

  • I have CVA and my sats are often 98-100% during an attack - even with my PF at 300 (as opposed to my usual 750!!!). I think sometimes with the coughing type you, or at least I, get a sort of hyperventilation effect as well so its deceptive.

  • Well been to see my asthma nurse today and got to finsh my steroids and antibiotics course and the amouts of puff of the steroids inhaler I have has been incresses. Got go back next week to see if they need to change my inhaler or try me on montelukast ( They block the chemical reaction involved in inflammation of the airways) I have never got anything more the 370 on my pf xxx

  • glad you had what sounds like a fairly productive visit. i know there are some people who have found that montelukast makes LOADS of difference, particularly people with more allergic asthma. so fingers crossed that if the increase in steroids doesnt work then that'll sort you! (also square tablets are always fun! lol!) how are you feeling now then?

  • I went to A&E on Tuesday night with exactly the same problem - asthma attack but with no wheeze and good stats. Health professionals don't seem to understand that asthma presents differently in different people. You can have strong lungs (e.g. through playing music and sports), but that doesn't mean your lungs aren't still sensitive. My airways tighten beyond belief to the point where it feels like I have multiple pairs of hands trying to strangle me up and down the length of my airways. I'm going to get a medical bracelet made so that if I end up in A&E with an attack again then I can give them the instructions of what I need and hopefully let them get on with it. You are not alone.

  • I know this is an old thread - I'm a diagnosed severe asthmatic, most of the time my airflow gets reduced. I very very rarely wheeze, I get chest tightness, coughing and shortness of breath.

  • I am diagnosed with brittle asthma. Stats are good. Spo 2 is perfect. But there are a sudden drop in my pefr, and chest tightness. After a round of oxygen driven nabulizer, im perfectly fine

  • The silent, no wheezing asthma can be the most dangerous...peak flow is best indicator of your condition.

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