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Inflammation in the airways causes them to narrow in one of three ways, they may flood with mucus, the inner lining of the bronchi may swell or the spiral muscles in the bronchi can constrict, or in the worst cases a combination of all three.

This leads to the characteristic wheezing as you struggle to breathe. Your chest will feel tight, you may cough up phlegm and you will be short of breath. In an acute attack, it will be difficult to breathe in, and you will feel as though someone is suffocating you.

Classic symptoms of an asthma attack include the following:

- Difficulty in breathing accompanied by loud wheezing, especially when breathing out.

- Hyperventilation - that is, breathing more rapidly than normal

- Pushed out chest and difficulty in speaking

- A blue tinge to the face, especially around the lips and mouth, a sign that you are not getting enough oxygen.

- Racing pulse and sweating

A severe acute asthma attack is a medical emergency and needs to be treated by a doctor and in hospital. The racing pulse could just mean that you are scared or it could be caused by the bronchodilator (the medication you are likely to administer yourself by means of a puffer) which stimulates the release of adrenaline.

In an asthma attack, make sure the sufferer uses reliever medication immediately, is that has no effect within 5 to 10 minutes call the emergency services, continue with the medication until help arrives. If not, you must bring the sufferer to the nearest hospital immediately.

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