24 year old female with a history of asthma and tobacco abuse presented with a progressively worsening shortness of breath and coughing. Her exam revealed extensive wheezing. She was admitted for further treatment of her asthma.

On the chest XR above, note hyperinflated lungs with depressed diaphragms on both sides. The hallmark of asthma is airway narrowing due to inflammation and airway muscle constriction. The patients are unable to fully exhale due to the narrowed airway. This causes air trapping leading to hyperinflation of both lungs.