| Subject | Contents |
| Definition | Wheezing is a high-pitched whistling sound produced by air flowing through narrowed breathing tubes, especially the smaller ones deep in the lung. It is a common finding in asthma and chronic obstructive pulmonary disease (COPD). |
| Alternative Names | Sibilant rhonchi |
| Considerations | The clinical importance of wheezing is that it is an indicator of airway narrowing, and it may indicate difficulty breathing. Wheezing is most obvious when exhaling (breathing out), but may be present during either inspiration (breathing in) or exhalation. Wheezing most often comes from the small bronchial tubes (breathing tubes deep in the chest), but it may originate if larger airways are obstructed or in certain cases of vocal cord abnormalities. |
| Common Causes | asthmabronchiectasisbronchiolitisbronchitisgastroesophageal reflux disease viral infection, especially in infants younger than 2 years old pneumoniaemphysema ( COPD ), especially when a respiratory infection is presentsmoking insect sting which causes an allergic reaction medications -- many asthmatics wheeze after taking aspirin inhalation of foreign matter into the lungs |
| Home Care | Take all of your medications, especially respiratory inhalers, as directed Exposure to moist, heated air (such as through a vaporizer or in a hot shower) may help alleviate some symptoms |
| Call your health care provider if | wheezing is occurring for the first time wheezing is associated with significant shortness of breath , bluish skin color, or mental status changes wheezing is a recurrent, unexplained problem wheezing is caused by an allergic reaction to a bite or medication If wheezing is severe or is accompanied by severe shortness of breath, you may have to go directly to the nearest emergency department. |
| What to expect at your health care provider's office | The medical history will be obtained and a physical examination performed.
Medical history questions documenting wheezing in detail may include:
time pattern
When did the wheezing begin? How long does it last? Does it occur often? Does it occur daily? What time of day does it occur? Is it worse at night or in the early morning? quality
What does the wheezing sound like? Does it make breathing difficult? Does it require stopping all physical activity ? Does it resolve without treatment? aggravating factors
What seems to cause it?
Eating certain foods? Taking certain medications? What makes it worse?
Exercise ? Stress ? Exposure to pollens, insects, dust, chemicals (perfumes, cosmetics)? Exposure to cold air? Cold or flu ? relieving factors
What helps relieve it?
Rest? Medications such as bronchodilators? other symptoms
What other symptoms are also present? Is there a fever ? Is there coughing ? Is there swelling of the lips or tongue? Is there panic or confusion ? Is there loss of voice ? Is there loss of consciousness ? Is there a bluish color to lips or nailbeds? Is there nasal congestion ? Are there puffy, red eyes ? Is there an insect bite? Has there been an episode of choking ? additional information
Is there a history of asthma or allergies ? What medications are being taken? Has there been exposure to tobacco smoke? Has there been a recent illness?
The physical examination may include listening to the lung sounds ( auscultation ). The possibility that foreign material has been swallowed may also be investigated in small children.
Diagnostic tests that may be performed are:
chest X-ray pulmonary function tests blood studies, possibly including arterial blood gases Treatment: Drugs to relieve narrowing of the airways, such as albuterol, are usually given by inhalation. Hospitalization may be required if the patient's breathing is particularly difficult or if close observation by medical personnel, intravenous medications, supplemental oxygen are required. In any case, the patient will need to be closely watched. If a diagnosis is made related to wheezing (such as asthma or COPD), further action to treat and manage the condition would be needed. |
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