Any breathlessness after the age of 40, appearing for the first time in winter, is cardiac asthma unless proved otherwise. Such patients should immediately have their blood pressure check-up done and if high needs immediate medical attention. First-onset breathlessness can also be an indication of angina or heart attack. However, the more common is winter asthma or acute exacerbation of winter COPD (chronic bronchitis). Asthma is reversible airway obstruction and COPD is irreversible airway obstruction. Sudden exposure to cold, humidity, pollution at lower levels in atmosphere can precipitate asthma in susceptible individuals. Winter is the time to increase the dose of asthma medicines.

If a person can speak a full sentence, the asthma attack is mild; if a person speaks broken sentences the asthma attack is moderate and if the person is able to speak only words then the asthma attack is severe. Severe attack of asthma needs immediate hospitalization.