What is wheezing?
Wheezing is an abnormal whistling sound that can occur when you inhale or exhale. Wheezing can result from either of two general respiratory problems: reduced airflow from narrowing of the airways and congestion in the lungs. These problems cause turbulent airflow in the lungs, which vibrates the airways. Wheezing is the result of these vibrations. Various diseases, disorders and conditions can cause wheezing.
Common wheezing causes include asthma and COPD (chronic obstructive pulmonary disease). Other possible causes include bronchitis, pneumonia, bronchiectasis (damage and widening of the large airways), cystic fibrosis, and tuberculosis. Lung cancer can cause wheezing, often with a cough that may bring up bloody sputum (hemoptysis).
Heart conditions can also lead to wheezing. For example, an acute episode of congestive heart failure can lead to fluid buildup in the lungs with wheezing.
Another less common cause of wheezing is anaphylaxis, which is a potentially fatal allergic reaction. Other symptoms of anaphylaxis include severe shortness of breath, chest pain, and sudden swelling of the throat, face or lips.
Wheezing treatment involves treating the underlying problem. This makes it important to see a doctor for a diagnosis of the cause. While doctors work to get the root problem under control, they may prescribe inhalers or other medicines to help ease wheezing.
Sometimes, wheezing can be a sign of a serious or life-threatening condition. Seek immediate medical care (call 911) for wheezing that occurs with any of these serious symptoms:
Change in level of consciousness or alertness
Pale or blue lips or fingernails
Rapid heart rate
Sharp chest pain
Sudden swelling of the throat, face or lips
Seek prompt medical care for mild or persistent wheezing without any other serious symptoms. If you have asthma, wheezing may be a sign that your medicines aren’t controlling your disease. Having wheezing or other asthma symptoms more than twice a week means it’s time to see your doctor. It may be necessary to adjust your asthma treatment plan.
What other symptoms might occur with wheezing?
Wheezing may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Wheezing when breathing may also involve symptoms that affect other body systems.
Symptoms that may occur along with wheezing
Wheezing may accompany other symptoms that affect the respiratory system including:
Chest pain that may worsen with breathing or coughing
Cough that may be dry or produce mucus or phlegm and may worsen with time
Difficulty breathing or shortness of breath
Stuffy or runny nose
Other symptoms that may occur along with wheezing
Wheezing may accompany symptoms that affect other body systems including:
Changes in heart rate
Flu-like symptoms, including fever, chills, headache and sore throat
Leg pain or swelling
Sleep problems or night sweats
Serious symptoms that might indicate a life-threatening condition
In some cases, wheezing can be life-threatening. Seek immediate medical care (call 911) for wheezing that occurs with any of these potentially life-threatening symptoms:
Bluish discoloration of the lips or fingernails
Changes in consciousness or alertness
Rapid heart rate
Shortness of breath, labored breathing, difficulty breathing, or choking
Sudden swelling of the face, lips or throat
What causes wheezing?
Wheezing can occur when narrowed airways reduce airflow or the lungs become congested. Various respiratory diseases, disorders and conditions can cause this. But other body systems can affect the lungs and airways as well.
Asthma and COPD are two of the most common causes of wheezing. Other possible causes include:
Allergies and allergic reactions, including anaphylaxis
Bronchiectasis (damage and widening of the large airways) and bronchiolitis (swelling of the smallest airways)
Certain medications, such as aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs), ACE (angiotensin-converting enzyme) inhibitors, and beta-blockers
Epiglottitis (life-threatening inflammation and swelling of the epiglottis, a tissue flap between the tongue and windpipe)
Foreign body in the windpipe or airway
Infections and inflammation, including bronchitis, croup and pneumonia
Lung cancer and tumors
Toxic inhalation of irritants, such as chlorine or ammonia vapors
What are the risk factors for wheezing?
Wheezing can affect anyone at any stage of life. However, babies may be more likely to develop wheezing due to their small airways. Babies and toddlers are also prone to viral respiratory infections, especially RSV (respiratory syncytial virus). Smaller airways in children make them more likely to have wheezing symptoms with asthma. In adults, wheezing is more common in smokers and people with COPD or heart failure.
You may be able to lower your risk of wheezing by:
Treating underlying medical conditions that can lead to wheezing
Wearing protective masks when handling potentially toxic chemicals
If you are at risk of developing wheezing due to a medical condition, regular medical care is an important part of your treatment plan. Seeing your doctor on a routine basis can help nip potential problems before they become serious.
How do doctors diagnose the cause of wheezing?
To diagnose the cause of wheezing, doctors will perform a physical exam and review your medical history. Your healthcare provider may ask you several questions about your symptoms, including:
When did your wheezing start?
Does anything seem to trigger your wheezing?
Do any other symptoms occur with wheezing, such as chest pain or coughing?
Does anything help improve or reduce your wheezing?
Have you been diagnosed with any chronic conditions, such as COPD?
The physical exam will include listening to your heart and lungs and taking a pulse oximetry on the tip of your finger. Pulse oximetry measures the amount of oxygen in your blood. It’s a painless test that tells your doctor how efficiently oxygen is moving from your lungs to your blood.
Your doctor may also order blood tests, a chest X-ray, or lung function tests.
What are the treatments for wheezing?
Since wheezing is a symptom of another problem, your doctor will need to treat the underlying cause. Treatment of two of the most common causes—asthma and COPD—usually involves inhalers. This may include using a bronchodilator inhaler to open airways and an inhaled corticosteroid to reduce inflammation. Short-term use of inhalers can also help treat bronchitis and other respiratory infections.
Additional treatments will depend on the condition that is causing or contributing to wheezing. For example, your doctor may prescribe antibiotics for bacterial respiratory infections or acid-blocking drugs for GERD.
When the underlying problem causes serious breathing problems and lack of oxygen, hospitalization may be necessary. Supplemental oxygen and IV (intravenous) medicines can support breathing while your doctor gets your condition under control.
For people who can remain at home, doctors may suggest using moist air to help relieve wheezing. This may involve using a cool-mist humidifier or a steam vaporizer. But even a simple hot shower can provide the humidity you need. Drinking plenty of fluids can also help relieve chest congestion and wheezing. Talk with your doctor about the best strategy for easing your wheezing.
What are the potential complications of wheezing?
Because wheezing can be due to serious diseases, failure to seek treatment can result in severe complications. Once you know the underlying diagnosis, it is important to follow the treatment plan your doctor recommends. This is the best way to avoid potential complications, such as disease progression, lung damage, or even death.