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Wheezing
| Definition |
| Wheezing is a high-pitched whistling sound produced by air flowing
through narrowed breathing tubes. Rales
are abnormal breath
sounds heard through a stethoscope. Rhonchi
are abnormal breath sounds heard through a stethoscope that sound
similar to snoring.
Also see breathing
sounds, abnormal. |
| Alternative names |
| sibilant rhonchi |
| Considerations |
The clinical importance of wheezing is that it is an indicator of difficult
breathing. In a child with a respiratory
infection, wheezing may occur before shortness
of breath is noticed.
Wheezing is most obvious when exhaling (breathing out) but may be
present when inhaling (breathing in) and exhaling.
Wheezing comes from the bronchial tubes (breathing tubes deep in the
chest), in contrast to croupy, crowing, or whooping sounds that come
from the trachea and larynx (voice box in the neck). |
| Common causes |
- asthma
- bronchiectasis
- bronchiolitis
- bronchitis
- gastroesophageal
reflux disease
- viral infection, especially in infants younger than 2 years old
- pneumonia
- emphysema
(COPD),
especially when a respiratory
infection is present
- smoking
- insect sting which causes an allergic
reaction
- medications--many asthmatics wheeze after taking aspirin
- inhalation of foreign matter into the lungs
- allergic
rhinitis
- allergies
(including food
allergies)
- tuberculosis
(TB)
Note: There may be other causes of wheezing. This list is not all
inclusive, and the causes are not presented in order of likelihood. The
causes of this symptom can include unlikely diseases and medications.
Furthermore, the causes may vary based on age and gender of the affected
person, as well as on the specific characteristics of the symptom such
as location, quality, time course, aggravating factors, relieving
factors, and associated complaints. Use the Symptom Analysis option to
explore the possible explanations for wheezing, occurring alone or in
combination with other problems.
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| Home care |
Drink plenty of fluids. It is best to drink water, but fruit juices or
soft drinks may be used if this will increase the amount of liquids
taken.
Use a cold mist vaporizer. If a vaporizer is not available, the shower
may be used to produce a mist. Unfortunately, it is difficult to get
much vapor down to the small breathing tubes. |
| Call your health care provider if |
- wheezing occurs in the presence of a fever.
- wheezing is a recurrent, unexplained problem.
- wheezing is caused by an allergic
reaction to a bite or medication.
- wheezing is associated with significant shortness
of breath, bluish
skin color, or mental
status changes.
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| 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
- blood studies, possibly including arterial
blood gases
Intervention:
Drugs to open up the breathing tube, such as adrenalin or aminophylline,
may be given by inhalation, aerosol, injection, by mouth, or by rectal
suppository. Hospitalization should only be necessary if fluids need to
be given intravenously or if humidification can't be achieved in any
other way. In any case, the patient will need to be closely watched.
Hospitalization may be required as a precautionary measure to prevent
the condition from getting worse.
After seeing your health care provider:
If a diagnosis was made by your health care provider related to
wheezing, you may want to note that diagnosis in your personal medical
record.
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