What is wheezing?
Wheezing is a high-pitched, coarse whistling sound that can occur when a person is breathing. Some wheezes are only heard with a doctor's stethoscope, but it is not uncommon for a wheeze to be heard with the naked ear.
The tone of the wheeze can vary depending on which part of the respiratory system is obstructed or narrowed. Narrowing in the upper respiratory system may make for a hoarser wheeze. Lower obstructions may have a more "musical" tone.
While wheezing most often is caused by an obstruction or narrowing of the small bronchial tubes in the chest, it can also be caused by an obstruction in the larger airways or vocal chords.
Wheezing is most obvious when a person is breathing out (exhaling), but can also be heard when breathing in (inhaling).
Who develops wheezing?
Anyone from infants to elderly adults can develop wheezing. Children with asthma often develop wheezing. Wheezing is quite common in infants. It is estimated that up to 25 to 30 percent of infants develop wheezing in their first year of life. Wheezing may be more common in babies due to their already smaller airways. Also, children under two are susceptible to a common, but easily treatable condition called bronchiolitis. This is caused by a viral respiratory infection and can cause wheezing.
In adults, smokers and individuals with emphysema and heart failure are more likely to develop wheezing.
What are the causes of wheezing?
The causes of wheezing widely vary. They range from chronic, usually manageable conditions such as asthma to very serious conditions that include heart failure. The most common causes of wheezing include:
- Asthma (a chronic respiratory condition that causes spasms in the bronchial tubes)
- Bronchitis (inflammation of the lining of the bronchial tubes)
- Bronchiolitis (most common in young children)
- Emphysema (a condition in which the air sacs of the lungs are damaged)
- Heart failure
- Pneumonia (an inflammation of the lungs caused by a virus or bacteria)
- Aspirating, or breathing, a foreign object into the lungs
- A severe acute allergic reaction called anaphylaxis due to foods or a stinging insect
Asthma and bronchitis are among the most common causes of wheezing in adults. Wheezing in these cases will usually be treated by treating the underlying conditions.
If you develop wheezing, you should call your health care provider as soon as possible for a consultation. If you are experiencing wheezing along with a severe shortness of breath or a blue tinge on your skin, seek health care right away.
What symptoms may occur with wheezing?
An audible high pitched whistling sound is the most apparent symptom of wheezing. Other symptoms that may accompany wheezing are:
- Shortness of breath
- Chest tightness
- Stuffy nose
- Loss of voice
- Swelling of the lips or tongue
- A bluish tinge around your mouth or nails
Symptoms vary depending on the cause of your wheezing.
How is wheezing diagnosed?
Your doctor will begin an exam by asking about how long and how often you have been wheezing. He or she will ask if the wheezing occurs with physical exertion, as when exercising, or if you wheeze all of the time. The doctor will also ask how long your wheezing lasts. Other questions the doctor will need to know include:
- Does it always occur in a certain place, where dust or allergens may make you wheeze?
- Does it occur at both day and night? Does rest help?
- Do you smoke?
- Do certain foods seem to cause your wheezing?
Your doctor will also perform a physical exam to listen to your breathing and lung sounds. He or she may also prescribe a lung X-ray, lung function tests, and blood tests to check your oxygen levels. If the patient is a child, the doctor may also check to make sure they did not swallow a small object such as a toy or coin that could cause the wheezing.
How is wheezing treated?
Treatment for wheezing depends on the underlying cause. Immediate treatment may include the use of supplemental oxygen to assist with breathing. Some patients may need to be hospitalized until their breathing improves.
If your wheezing is determined to be caused by asthma, you will likely be prescribed a type of inhaler to reduce inflammation and open your airways. Inhaled corticosteroids and pills such as montelukast (Singulair®) are anti-inflammatory medicines used to treat asthma.
If your wheezing is determined to be caused by bronchitis, you may be prescribed a bronchodilator such as albuterol (Proair® HFA, Proventil® HFA, Ventolin® HFA) or an antibiotic to deal with a bacterial infection. This should eliminate your wheezing as you heal.
Other causes of wheezing may require different treatment. Whatever the cause of your wheezing, using a vaporizer or sitting in an area with moist, heated air such as a shower, can help relieve your symptoms. Your doctor can come up with the best plan for your condition.
This article was reviewed by Brian C. Schroer, MD. Dr. Schroer is Associate Staff in Cleveland Clinic Children’s Hospital Center for Pediatric Allergy. He sees pediatrics patients at the Main Campus and patients of all ages at the Solon and Twinsburg Family Health Centers.
- Weiss LN. The diagnosing of wheezing in children. Am Fam Physician2008;77:1109–14. www.aafp.org. Accessed April 9, 2013.
- Wheezing. The Merck Manuals: The Merck Manual for Healthcare Professionals. www.merck.com. Accessed April 9, 2013.
- Braun-Fahrländer C, Riedler J, Herz U, et al.; Allergy and Endotoxin Study Team. Environmental exposure to endotoxin and its relation to asthma in school-age children. N Engl J Med 2002;347:869–77.
- Gong H JR. Wheezing and Asthma. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 37. Available from: www.ncbi.nlm.nih.gov
© Copyright 1995-2013 The Cleveland Clinic Foundation. All rights reserved.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/15/2013…#15203