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Wheezing

Definition

Wheezing is a high-pitched whistling sound during breathing. It occurs when air flows through narrowed breathing tubes.

Alternative Names

Sibilant rhonchi

Considerations

Wheezing is a sign that a person may be having breathing problems. The sound of wheezing is most obvious when breathing out (exhaling), but may be heard when taking a breath (inhaling).

Wheezing most often comes from the small breathing tubes (bronchial tubes) deep in the chest, but it may be due to a blockage in larger airways or in persons with certain vocal cord problems.

Causes

• Asthma
• Breathing a foreign object into the lungs
• Bronchiectasis
• Bronchiolitis
• Bronchitis
• Emphysema (COPD), especially when a respiratory infection is present
• Gastroesophageal reflux disease
• Heart failure (cardiac asthma)
• Insect sting that causes an allergic reaction
• Medications (particularly aspirin)
• Pneumonia
• Smoking
• Viral infection, especially in infants younger than age 2

Home Care

Take all of your medications, especially respiratory inhalers, as directed.

Sitting in an area where there is moist, heated air may help relieve some symptoms. This can be done running a hot shower or by using a vaporizer.

When to Contact a Medical Professional

Call your health care provider if:

• Wheezing occurs for the first time
• Wheezing occurs with significant shortness of breath, bluish skin, confusion, or mental status changes
• Wheezing keeps occuring without explanation
• Wheezing is caused by an allergic reaction to a bite or medication

If wheezing is severe or occurs with severe shortness of breath, you may have to go directly to the nearest emergency department.

What to Expect at Your Office Visit

Your doctor will perform a physical examination and ask questions about your medical history and symptoms, including:

• When did the wheezing begin?
• How long does it last?
• When and how often does it occur?
• Is it worse at night or in the early morning?
• What does the wheezing sound like?
• Does it make breathing difficult?
• What seems to cause it?
  • Eating certain foods?
  • Taking certain medications?
• Do any of the following things make it worse?
  • Being around pollens, insects, dust, chemicals (perfumes, cosmetics)
  • Being in cold air
  • Exercise
  • Sickness (such as a cold or the flu)
  • Stress
• Does it go away without treatment?
• What helps relieve it?
  • Rest?
  • Medications such as bronchodilators?
• Do you have any other symptoms, such as:
  • Bluish color to lips or nails
  • Coughing
  • Fever
  • Loss of consciousness
  • Loss of voice
  • Panic or confusion
  • Puffy, red eyes
  • Stuffy nose
  • Swelling of the lips or tongue
• Did you have an episode of choking?
• Did you have an insect bite?
• Do you have a history of asthma or allergies?
• What medications do you take?
• Have you been around tobacco smoke?
• Have you recently been sick?

The physical examination may include listening to the lung sounds (auscultation). If your child is the one with symptoms, the doctor will make sure he or she did not swallow a foreign object.

Tests that may be done include:

• Blood work, possibly including arterial blood gases
• Chest x-ray
• Lung function tests

Your doctor may prescribe drugs to relieve narrowing of the airways, such as albuterol.

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

Schatz M. Asthma in adolescents and adults. In: Rakel P, Bope ET, eds. Conn’s Current Therapy 2008. 60th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 189.

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