Wheezing during expiration alone indicates milder obstruction than wheezing during both inspiration and expiration, which suggests more severe airway narrowing. By contrast, turbulent flow of air through a narrowed segment of the large, extrathoracic airways produces a whistling inspiratory noise stridor Stridor Stridor is a high-pitched, predominantly inspiratory sound. It is most commonly associated with acute disorders, such as foreign body aspiration, but can be due to more chronic disorders, such Small airway narrowing may be caused by bronchoconstriction, mucosal edema, or external compression, or partial obstruction by a tumor, foreign body, or thick secretions.
Asthma Asthma Asthma is a disease of diffuse airway inflammation caused by a variety of triggering stimuli resulting in partially or completely reversible bronchoconstriction.
Symptoms and signs include dyspnea Alpha-1 antitrypsin deficiency and various occupational But wheezing may occur in other disorders affecting the small airways, including heart failure Heart Failure HF Heart failure HF is a syndrome of ventricular dysfunction.
Left ventricular failure causes shortness of breath and fatigue, and right ventricular failure causes peripheral and abdominal fluid Sometimes, healthy patients manifest wheezing during a bout of acute bronchitis Acute Bronchitis Acute bronchitis is inflammation of the tracheobronchial tree, commonly following an upper respiratory infection that occurs in patients without chronic lung disorders The cause is almost always Diagnosis is suspected Prolonged expiratory When patients are in significant respiratory distress, evaluation and treatment proceed at the same time.
History of present illness should determine whether the wheezing is new or recurrent. If recurrent, patients are asked the previous diagnosis and whether current symptoms are different in nature or severity. Particularly when the diagnosis is unclear, the acuity of onset eg, abrupt or gradual , temporal patterns eg, persistent vs intermittent, seasonal variations , and provoking or exacerbating factors eg, current upper respiratory infection, allergen exposure, cold air, exercise, feeding in infants are noted.
Important associated symptoms include shortness of breath, fever, cough, and sputum production. Review of systems should seek symptoms and signs of causative disorders, including fever, sore throat, and rhinorrhea respiratory infection ; orthopnea, paroxysmal nocturnal dyspnea, and peripheral edema heart failure Heart Failure HF Heart failure HF is a syndrome of ventricular dysfunction.
Prolonged reflux may lead to esophagitis, stricture, and rarely metaplasia Past medical history should ask about conditions known to cause wheezing, particularly asthma, COPD, and heart failure. Patients with known disease should be asked about indicators of disease severity, such as previous hospitalization, intubation, or intensive care unit admission.
Also, conditions that predispose to heart failure are identified, including atherosclerotic or congenital heart disease and hypertension. Smoking history and exposure to secondhand smoke should be noted. Vital signs are reviewed for presence of fever, tachycardia, tachypnea, and low oxygen saturation. Any signs of respiratory distress eg, accessory muscle use, intercostal retractions, pursed lip breathing, agitation, cyanosis, decreased level of consciousness should be immediately noted.
Examination focuses on the lungs, particularly adequacy of air entry and exit, symmetry of breath sounds, and localization of wheezing diffuse vs localized; inspiratory, expiratory, or both.
Any signs of consolidation eg, egophony, dullness to percussion or crackles should be noted. In severe cases, wheezing can sometimes be a sign of a collapsed airway or occur as a result of the inhalation of toxic smoke or chemicals. People with anaphylaxis will need an immediate injection of epinephrine. Anyone with a severe allergy should carry two epinephrine auto-injectors with them at all times.
Asthma can be a lifelong condition, but people can manage their symptoms with a variety of treatments. These can include medications that a person takes through an inhaler or in the form of a pill or injection. Many of these medicines work to reduce swelling and relax the muscles in the airways. For conditions affecting the vocal cords, speech therapy or deep breathing exercises can help relax the muscles in the throat.
People with acute bronchitis will usually recover within a few days or weeks. Taking an over-the-counter anti-inflammatory drug, such as ibuprofen, can help speed this process. A doctor may prescribe antibiotics for bacterial infections. People with chronic bronchitis may need to take prescribed medication, make lifestyle changes, or, in some cases, use an extra oxygen supply. Treatment for lung cancer will depend on the stage of the disease and how it has spread in the body.
A team of doctors will create an individualized treatment plan that may involve surgery, chemotherapy , or radiation therapy. If a person is wheezing for an unknown reason or thinks that they might have asthma or COPD, they should see a doctor. Anyone who notices signs of pneumonia, has difficulty breathing, or sees that their skin has turned blue should seek emergency help. People should also seek emergency medical attention if they are having an asthma attack or have started wheezing after:.
If people have had an anaphylactic reaction, they should seek emergency help immediately, even if they have taken an epinephrine injection and are feeling better. People may experience expiratory and inspiratory wheezing from lung conditions, such as asthma or COPD. Temporary conditions, such as respiratory infections, can also cause both types of wheezing. Expiratory wheezing is more common and may be a result of a mild infection affecting the airways.
An obstruction of the upper airways can cause inspiratory or expiratory wheezing. If people are experiencing both expiratory and inspiratory wheezing, they may have a more serious issue and should seek medical help. If people are wheezing for no known reason, are having difficulty breathing, or have a tightening of the chest, they should seek medical help immediately.
Wheezing can be caused by respiratory problems, such as asthma, allergies, and colds. A person can stop or manage wheezing at home without an inhaler…. If your wheezing is severe, your doctors may give you an oxygen mask to steady your breathing and bronchodilators to help open your airways. In this case, they may recommend you stay at the hospital overnight. If inflammation is causing your wheezing, your doctor will prescribe anti-inflammatory medications like steroids to reduce swelling and open your airways for easier breathing.
If your wheezing is caused by an infection, you may be prescribed antibiotics to treat the condition and associated symptoms. Wheezing can occur when you inhale and exhale.
Though asthma and inflammation are common causes of this symptom, wheezing can be a sign of a more serious condition. If your wheezing is accompanied with breathing difficulties, seek immediate medical attention. Discuss your concerns with your doctor to receive a proper diagnosis and the best treatment for your condition. Heartburn is the most common symptom of acid reflux. Others are asthmatic in nature. Learn more about the relationship between acid reflux and asthma.
Abnormal breath sounds can indicate a lung problem, such as an obstruction, inflammation, or infection. Learn about breath sounds and what they may…. Wheezing is a high-pitched whistling sound made while you breathe. Caused by narrowed airways or inflammation,. Learn more about measuring your peak flow rate and 7 meters on the market.
Pulmonary function tests PFTs are a group of tests that measure how well your lungs work.
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