In a patient experiencing an acute asthma attack, which symptom can be particularly concerning?

In a patient experiencing an acute asthma attack, the use of accessory muscles for breathing is particularly concerning because it indicates significant respiratory distress. When a person has difficulty breathing due to narrowed airways and reduced airflow, the body compensates by recruiting additional muscles to assist with breathing. These muscles, including those in the neck and shoulders, are not normally needed for quiet breathing. Their use suggests that the patient is working much harder to breathe, which can lead to increased fatigue and potentially respiratory failure if not addressed promptly.

The other symptoms, such as an increased heart rate, prolonged expiration phase, and wheezing on expiration, are also notable features of an asthma attack. However, the reliance on accessory muscles highlights a more critical level of respiratory impairment. This degree of distress requires immediate intervention to stabilize the patient and restore effective breathing patterns.