Wheezing
Wheezing is characterized by a whistling or grating sound during breathing, typically indicating a narrowing or blockage in the airways. This symptom can be accompanied by feelings of chest tightness, shortness of breath, and anxiety due to breathing difficulties. Common causes of chronic wheezing include asthma and emphysema, while temporary wheezing may arise from conditions such as bronchitis, pneumonia, viral infections, allergies, smoking, or inhalation of irritants. The timing of the wheeze can provide insight into its underlying cause; for example, wheezing at the end of exhalation often suggests bronchitis, while wheezing at the beginning of exhalation is typically associated with asthma. Treatment focuses on addressing the underlying disorder, which may involve medications like bronchodilators and corticosteroids to alleviate symptoms and inflammation. In more severe cases, hospitalization might be necessary for advanced interventions. Despite advancements in treatment, accurately diagnosing the cause of wheezing remains a challenging task, particularly in resource-limited settings where respiratory illnesses can have significant consequences. Understanding wheezing aids in recognizing its implications for respiratory health and the importance of seeking medical attention when necessary.
Subject Terms
Wheezing
Also known as: Sibilant rhonchi
Anatomy or system affected: Chest, lungs, respiratory system
Definition: Noise produced in the respiratory tract when air passes through narrowed or partially blocked breathing tubes
Causes and Symptoms
Wheezing is a whistling or grating noise created when a person’s breathing passages are narrowed or blocked. It can be accompanied by tightness in the chest or shortness of breath, as well as anxiety due to difficulty breathing.
Wheezing is a symptom of several disorders. The most common causes of chronic wheezing are asthma and emphysema. Temporary wheezing due to obstruction by mucus can be caused by bronchitis, pneumonia, viral infections, and allergies, as well as smoking and inhalation of fumes or foreign matter. The exact timing of the wheeze can give clues to its cause. Bronchitis causes a noise at the very end of a complete exhalation. Wheezing at the start of exhalation usually indicates asthma or emphysema. Wheezing only when inhaling is a sign of asthma.
Conditions such as gastroesophageal reflux disease, vocal cord dysfunction, and genetic disorders that affect the lungs, such as cystic fibrosis, can also cause wheezing. Patients with heart failure often develop cardiac asthma caused by a pulmonary edema, in which fluid builds up in the lungs because of inefficient pumping of the heart. Less commonly, wheezing may be a symptom of tumors, joint disorders, or heart aneurysms. Radiation therapy for cancer or other diseases can also cause the airways to constrict.
Treatment and Therapy
Treatment for wheezing involves treating the underlying disorder. Doctors may do blood work or administer X-rays; antibiotics and antihistamines may be prescribed for allergies or infections.
Medicines are often given to manage the discomfort and anxiety this symptom causes. For chronic wheezing, respiratory inhalers are usually prescribed. Bronchodilators give temporary relief by relaxing the airways. Bronchodilators can cause dependence, however, and patients should be monitored continually by a doctor. More severe symptoms may require regular use of corticosteroid inhalers, which reduce inflammation in the airways and make them less likely to constrict.
For mild wheezing, drinking warm liquids and inhaling moist, heated air, such as from a vaporizer or a hot shower, is helpful. Severe wheezing may require hospitalization and use of a strong bronchodilator, an oxygen tent, or a respiratory tube.
Perspective and Prospects
The Western use of bronchodilators for treatment of bronchitis and asthma began in the nineteenth century, although Indian medicine had used plant derivatives for similar effect for thousands of years. Corticosteroids became standard treatment during the 1970s.
Although wheezing is a well-managed symptom, determining the precise cause is often extremely difficult. This is especially true for doctors with limited resources in developing countries, where pneumonia is the most common respiratory cause of child mortality.
Bibliography
"Adult-Onset Asthma." WebMD, 7 Aug. 2022, www.webmd.com/asthma/adult-onset-asthma. Accessed 15 July 2023.
Barnes, Peter J., and Simon Godfrey. Asthma and Wheezing in Children. Taylor & Francis, 1999.
"Bronchitis." NHS Inform, 13 Feb. 2023, www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/bronchitis. Accessed 15 July 2023.
Silverman, Michael, ed. Childhood Asthma and Other Wheezing Disorders. Oxford University Press, 2002.
"Wheezing." MedlinePlus, medlineplus.gov/ency/article/003070.htm. Accessed 15 July 2023.