Wheezing
Sibilant rhonchi; Wheezing asthma; Wheezing - bronchiectasis; Wheezing - bronchiolitis; Wheezing - bronchitis; Wheezing - COPD; Wheezing - heart failure
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
Considerations
Wheezing is a sign that a person may be having breathing problems. The sound of wheezing is most obvious when breathing out (exhaling). It may also be heard when breathing in (inhaling).
Wheezing most often comes from the small breathing tubes (bronchial tubes) deep in the lungs. But it may be due to a blockage in larger airways or in persons with certain vocal cord problems.
Causes
Causes of wheezing may include any of the following:
-
Asthma
Asthma
Asthma is a disease that causes the airways of the lungs to swell and narrow. It leads to wheezing, shortness of breath, chest tightness, and coughi...
- Breathing a foreign object into the airways to the lungs
-
Damage and widening of the large airways in the lungs (
bronchiectasis
)
Bronchiectasis
Bronchiectasis is a disease in which the large airways in the lungs are damaged. This causes the airways to become wider. Bronchiectasis can be pres...
-
Swelling and mucus buildup in the smallest air passages in the lungs (
bronchiolitis
)
Bronchiolitis
Bronchiolitis is swelling and mucus buildup in the smallest air passages in the lungs (bronchioles). It is usually due to a viral infection....
-
Swelling and mucus buildup in the main passages that carry air to the lungs (
bronchitis
)
Bronchitis
Acute bronchitis is swelling and inflamed tissue in the main passages that carry air to the lungs. This swelling narrows the airways, which makes it...
- COPD, especially when a respiratory infection is present
-
Acid reflux disease
Acid reflux disease
Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents leak backwards from the stomach into the esophagus (the tube from...
- Heart failure (cardiac asthma)
-
Insect sting that causes an
allergic reaction
Allergic reaction
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
- Certain medicines (particularly aspirin)
-
Infection of the lungs (
pneumonia
)
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
- Smoking
- Viral infection, especially in infants younger than age 2
Home Care
Take all of your medicines as directed.
Sitting in an area where there is moist, heated air may help relieve some symptoms. This can be done by running a hot shower or using a vaporizer.
When to Contact a Medical Professional
Call your health care provider if wheezing:
- Occurs for the first time
-
Occurs with significant
shortness of breath
,
bluish skin
, confusion, or
mental status changes
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
Bluish skin
Cyanosis is a bluish color to the skin or mucous membrane that is usually due to a lack of oxygen in the blood.
Mental status changes
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
- Keeps occurring without explanation
- Is caused by an allergic reaction to a bite or medicine
If wheezing is severe or occurs with severe shortness of breath, you should go directly to the nearest emergency department.
What to Expect at Your Office Visit
The provider will perform a physical exam and ask about your medical history and symptoms. Questions about your wheezing may include when it started, how long it has lasted, when it is worse, and what might have caused it.
The physical exam may include listening to the lung sounds ( auscultation ). If your child has the symptoms, the provider will make sure your child didn't swallow a foreign object.
Auscultation
Auscultation is listening to the sounds of the body during a physical examination.
Tests that may be done include:
-
Blood work, possibly including
arterial blood gases
Arterial blood gases
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
-
Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
- Lung function tests
A hospital stay may be needed if:
- Breathing is particularly difficult
- Medicines need to be given through a vein (IV)
- Supplemental oxygen is required
- The person needs to be closely watched by medical personnel
References
Kliegman RM, Stanton BF, St. Geme JW, Schor NF. Wheezing, bronchiolitis, and bronchitis. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 391.
Woodruff PG, Bhakta NR, Fahy JV. Asthma: pathogenesis and phenotypes. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 41.
-
What causes wheezing?
Animation
-
Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
Review Date: 5/18/2016
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.