Wheezing Overview
Wheezing is a high-pitched whistling sound that happens when a person breathes. It’s caused by narrowed airways or inflammation. Wheezing is the shrill whistle or coarse rattle you hear when your airway is partially blocked.
Wheezing is usually a symptom of different medical conditions. While some of these issues are temporary (like allergies), others can be quite serious and require medical attention.
It might be blocked because of an allergic reaction, a cold, bronchitis or allergies. Wheezing is also a symptom of asthma , pneumonia, heart failure and more. It could go away on its own, or it could be a sign of a serious condition.
Some wheezes can only be heard with a stethoscope, but often they can be heard with the human ear. Wheezing is more obvious when you breathe out (exhale), but can also be heard when you breathe in (inhale).
The tone of the wheeze can vary depending on which part of the respiratory system is blocked or narrowed. Narrowing in the upper respiratory system may make for a hoarser wheeze. Lower obstructions may have a more musical tone, similar to a how a wind instrument like a clarinet might sound.
Anyone including infants and elderly adults can develop wheezing. Children with asthma often develop it. Wheezing is also quite common in infants, it is estimated that up to 25% to 30% of infants develop wheezing in their first year of life.
Wheezing may be more common in babies because of their 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 inflammation.
Many people with respiratory allergies know that wheezing often comes with hay fever season. It may also happen because of respiratory infections like acute bronchitis. But chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and asthma are the most common causes.
A number of treatments can ease wheezing. Your doctor should keep close watch if you have asthma, severe allergies, long-term bronchitis, emphysema, or COPD. You also may need to see a specialist such as an allergist or pulmonologist.
Causes of Wheezing
One of the most common causes of wheezing is asthma, which is when there is a swelling or narrowing of the throat or the airways to your lungs. But wheezing can be caused by a variety of other issues.
The whistling sound happens when air moves through narrowed airways, much like the way a whistle or flute makes music.
Many health problems can cause wheezing, including the following:
Lung Diseases
- Asthma is a chronic condition that causes spasms and swelling in the bronchial tubes. Wheezing in asthma can be triggered by exposure to airborne allergens such as pollen, mold, animals, or house dust. Viral illnesses can also make asthma symptoms worse.
- Bronchitis is inflammation of the lining of the bronchial tubes.
- Bronchiolitis is most common in young children.
- COPD is chronic obstructive pulmonary disorder, a long-term inflammation and damage of the bronchial tube lining, most commonly from smoking cigarettes.
- Cystic Fibrosis (CF). In patients who have CF, thick mucus clogs the airways and makes breathing difficult.
- Pneumonia is an inflammation of the lungs caused by a virus or bacteria.
- Respiratory Syncytial Virus (RSV) is a seasonal lung infection that can lead to bronchiolitis or pneumonia.
- Aspirating (breathing) a foreign object into the lungs.
Vocal Cord Issues
Vocal cord dysfunction (VCD), which is often confused for asthma, is a condition in which the vocal cords don’t open correctly. A few symptoms of this issue are:
- Difficulty breathing (shortness of breath)
- Coughing
- Wheezing
Allergies
Even if you don’t have asthma, allergies can cause you to feel like you’re short of breath. They can also cause wheezing. The allergy symptoms you experience depend on the type of thing you’re allergic to, such as pollen or pet dander.
Anaphylaxis which is an acute and serious allergic reaction, may also cause wheezing. Anaphylaxis is a medical emergency. You should call 911 or your local emergency services if you begin to experience anaphylaxis symptoms, such as:
- Dizziness
- Swollen throat or tongue
- Trouble breathing (shortness of breath)
Heart Disease
Heart failure can cause wheezing or a “breathless” feeling. This wheezing is typically caused by fluid buildup in the lungs.
Digestive Problems
Gastroesophageal Reflux (GERD) which is chronic acid reflux, is often closely associated with asthma. This chronic acid reflux can worsen asthma symptoms by irritating the airways and lungs. Patients with both asthma and GERD may notice an increase in their wheezing when their GERD flares up.
Lifestyle Factors
Smoking can:
Risk Factors for Wheezing
Wheezing can happen to anyone. However, certain risk factors can increase your chances of developing a wheeze. Hereditary illnesses, such as asthma, can run in families.
Wheezing can also occur in:
- Patients with lung cancer
- Toddlers in day care or with older siblings, due to the increased exposure to infection
- People who are current smokers and smoked in the past
Avoiding risk factors, such as smoking, may help improve wheezing. You should stay away from triggers that make you wheeze, such as pollen and other allergens, when possible.
Diagnosing the Cause of Wheezing
To be able to diagnose what is is causing the wheezing, your doctor will ask you the following questions:
- Are you a smoker?
- How long have you been wheezing?
- Does it happen during exercise?
- If you wheeze all the time?
- Wheezing occurs more during the day, or at night?
- Does rest help control the wheezing?
- Do you wheeze when you breathe in, or out, or both in and out?
- Does eating certain foods cause your wheezing?
- Blood test o check your oxygen levels. (Those that are too low could signal a lung problem.)
- X-rays to get a picture of your lungs
- Lung function tests to see how well they’re working
If your child is wheezing, their doctor might check to see if they’ve swallowed or inhaled something small.
Treatment of Wheezing
Because wheezing is usually a symptom of an underlying condition, treating wheezing involves treating the condition.
When it comes to certain lung conditions, prescription anti-inflammatory medications can decrease inflammation and excess mucus in the airways. These medications typically come in the form of inhalers, but they’re also available as liquid medication used via a nebulizer.
To start with your doctor may give you oxygen, which is used at the first sign of symptoms, such as wheezing, and you might need to stay in the hospital until you get better. After that, treatment depends on what is causing the wheezing. Some common causes and treatments include the following:
Asthma
Asthma cannot be cured, but it can be managed with:
- Bronchodilator medications to ease inflammation and open the patients airways
- Inhaled corticosteroids and controller medications to fight inflammation, which work on easing swelling and mucus in airways
- Leukotriene receptor antagonists to prevent asthma and allergy symptoms
- Quick-relief medications (used at the first sign of symptoms, such as wheezing)
- Biologics(for patients with chronic, persistent symptoms)
Bronchitis
Typically, bronchitis clears up on its own, but if you develop chronic bronchitis, there are medications that can help. These include bronchodilators and steroids, which work to open the airways. They can be taken either via an inhaler or pills.
Mucolytic medications can help to thin mucus in the lungs so you can cough it up more easily.
Prevention of Wheezing
In the case of certain chronic health conditions, such as asthma, wheezing can’t usually be prevented without medical help. However, taking your prescribed medications as soon as you start to feel the symptom coming on can help provide quicker relief.
Other ways to lessen wheezing include:
- Avoiding smoking
- Reducing your exposure to allergy or asthma triggers when possible
- Working on managing underlying symptoms
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