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Wheezing

Overview

It is a natural phenomenon that when air passes through a narrow passage, it creates a whistling sound. Similarly, when your airway is constricted or inflamed, it releases a high-pitched sound as air passes. This is known as wheezing. Wheezing is a sign of a medical condition related to your respiratory system. It can occur when you inhale or exhale air. Wheezing is common in chronic lung diseases, but it can also occur due to other reasons. 

Causes

The most common causes of wheezing are asthma and chronic obstructive lung disease (COPD). During these chronic conditions, the respiratory passage becomes narrow or heavy breathing occurs to fulfill the oxygen demand. Due to the passage of air through a narrow path, the typical whistle sound can be heard. Some other respiratory diseases where wheezing may occur include emphysema, chronic bronchitis, bronchiolitis, cystic fibrosis, pneumonia, obstructive sleep apnea, and respiratory syncytial virus disease (RSV).

Another condition that can cause wheezing is s vocal cord dysfunction (VCD). The symptoms of this condition are often confused with asthma because it also causes wheezing, difficulty in breathing, and cough. Allergic reactions to dust, pollen, or other substances can also cause your respiratory symptom to collapse for a short time. Other causes of wheezing include smoking, epiglottitis, airway obstruction, gastroesophageal reflux disease (GERD), heart failure, and lung cancer

Risk Factors And Epidemiology

Wheezing can occur in anyone, but age is one of the risk factors. Young children or older people can develop wheezing because of various causes. This is because their immune systems are weaker and more exposed to certain diseases. People with chronic lung diseases such as asthma or COPD are at the highest risk because any triggering factor, such as dust, pollen, etc., can worsen their condition and lead to wheezing. Smoking is another factor that can cause constriction of the airway. The lungs of smokers get weakened over time, and they have an increased risk of developing diseases like emphysema or lung cancer.

Signs And Symptoms

Wheezing itself is a symptom of multiple diseases. Mild wheezing can occur with cough or sneezing in case of infections. Long-term sneezing occurs in chronic lung conditions, which will also present with other symptoms such as shortness of breath, chest tightness, labored breathing, etc. If you develop severe wheezing after being stung by a bee, eating or inhaling an allergen, or due to choking, seek medical help immediately. Difficulty in breathing, heavy breathing, and a bluish tinge of the skin are signs of severe lack of oxygen. 

Diagnosis

The diagnostic procedure begins with obtaining a detailed history of the symptoms and other factors such as allergies, smoking, preexisting medical conditions, etc. This is followed by a physical examination where your doctor will notice your breathing rate, breathing pattern, possible airway obstruction, breathing sounds, etc. A stethoscope is used to determine an irregularity in heart or lungs sounds. Further diagnostic tests will be required to make a conformational diagnosis if a particular disease is suspected. These may include chest x-ray, pulse oximetry, electrocardiography (EKG), spirometry, plethysmography, and necessary blood tests.  

Differential Diagnosis

Wheezing is a symptom of multiple respiratory diseases and a few other conditions. The original cause needs to be identified and differentiated from other medical conditions based on symptoms, history, physical examination, and appropriate diagnostic tests.

Treatment

Treatment of wheezing is based on its cause and severity. If you develop a medical emergency, the first step will be to secure your airway, breathing, and circulation. Oxygen supply is given to improve oxygen saturation level. Once your vitals have been stabilized, your doctor will follow with suitable medications or other treatment options to cure the original cause. If you suffer from an asthma or COPD attack, bronchodilators or corticosteroids are given to dilate your airway passage. This way, the wheezing sound resolves in a few minutes to a few hours. If you are old or have any other chronic disease, your doctor will also guide you about some lifestyle changes to reduce the risk of this condition.

If you have an inflammatory lung disease, anti-inflammatory medications are given in the form of inhalers or taken via nebulization. Excessive mucous buildup can be resolved by mucolytic agents. Other medications such as bronchodilators or corticosteroids are prescribed in specific dosages in cases of asthma, COPD, or inflammatory diseases. 

Prognosis

The prognosis of wheezing depends on the cause and severity of your condition. Chronic diseases like asthma, COPD, or emphysema can last from months to years. With prescribed medications, you can significantly reduce the chance of developing wheezing and its associated symptoms. 

Prevention

It is difficult to prevent wheezing since it is not predictable and can occur at any time. However, if you have a preexisting heart or lung disease, you will need to follow some guidelines given by your doctor to improve your life quality. In case of chronic lung disease, keep your inhaler and other medications at hand at all times. Walking or exercising for 15 – 30 minutes a day can improve the functions of your heart and lungs. Avoid smoking, alcohol, and drug abuse. If you are allergic to dust or pollen, limit your time outside and wear a mask during traveling. Avoid air-polluted areas to the best possible extent.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on June 04, 2023.

 

References

Wheezing: Causes, Diagnosis, Treatment, and Remedies (webmd.com)

https://www.webmd.com/asthma/understanding-wheezing-basics

Wheezing: MedlinePlus Medical Encyclopedia

https://medlineplus.gov/ency/article/003070.htm

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