Wheezing

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Introduction

What is wheezing?

Wheezing is a whistling sound made during inhalation or exhalation. Wheezing can result from either of two respiratory conditions: reduced airflow resulting from narrowing of the airways or congestion in the lungs.

Causes of wheezing include asthma and infection and inflammation of the lungs (pneumonia) or bronchi (bronchitis). Other common causes include chronic obstructive pulmonary disease (COPD), bronchiectasis (destruction and widening of the airways), cystic fibrosis, and tuberculosis. Lung cancer can cause wheezing that is accompanied by a cough that may bring up bloody sputum (hemoptysis).

Heart conditions can also lead to wheezing, such as when an acute episode of congestive heart failure leads to fluid buildup in the lungs. Another less common cause of wheezing is a serious allergic reaction (anaphylaxis), which may be accompanied by severe shortness of breath, chest pain, and sudden swelling of the throat, face and lips.

In some cases, wheezing can be a sign of a serious or life-threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms, such as severe difficulty breathing and sharp chest pain, which may be accompanied by pale or blue lips, a change in level of consciousness or alertness, or rapid heart rate. Seek immediate medical care for sudden swelling of the throat, face, or lips, and difficulty breathing, as these can be signs of an anaphylactic reaction.

Seek prompt medical care if you are being treated for wheezing but mild symptoms recur or are persistent.

Symptoms

What other symptoms might occur with wheezing?

Wheezing may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the respiratory tract may also involve other body systems.

Symptoms that may occur along with wheezing

Wheezing may accompany other symptoms that affect the respiratory system including:

  • Absence of breathing (apnea)

  • Chest pain or pressure

  • Cough that gets more severe over time

  • Coughing up blood (hemoptysis)

  • Coughing up clear, yellow, light brown, or green mucus

  • Difficulty breathing

  • Loose, wet cough that produces thick white or yellow phlegm

  • Rapid breathing (tachypnea)

  • Shortness of breath

Cardiovascular symptoms that may occur along with wheezing

Wheezing may accompany symptoms that are related to the cardiovascular system including:

  • Absence of heart beat (asystole)

  • Chest pain or pressure

  • Slow heart rate (bradycardia)

Other symptoms that may occur along with wheezing

Wheezing may accompany other symptoms that affect the respiratory system including:

Serious symptoms that might indicate a life-threatening condition

In some cases, wheezing can be a symptom of a life-threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Hemoptysis (coughing-up blood)

  • Rapid heart rate (tachycardia)

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not
    breathing, or choking

  • Sudden swelling of the face, lips, throat or tongue

Causes

What causes wheezing?

Wheezing can result from either of two respiratory conditions: reduced airflow resulting from narrowing of the airways or congestion in the lungs. Causes of wheezing include allergies, asthma, infection and inflammation of the lungs or bronchi, other respiratory diseases, and heart conditions.

Respiratory causes of wheezing

Wheezing may be caused by respiratory disorders including:

  • Acute bronchitis

  • Asthma or allergies

  • Bronchiectasis (destruction and widening of the large airways)

  • Bronchiolitis (inflammation of the smallest airways within the lungs)

  • Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis

  • Epiglottitis (life-threatening inflammation and swelling of the epiglottis, a tissue flap between the tongue and windpipe)

  • Foreign object in the airway

  • Lung cancer

  • Pneumonia

  • Respiratory syncytial virus infection

Other causes of wheezing

Wheezing can also have other causes including:

Serious or life-threatening causes of wheezing

In some cases, wheezing may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These conditions include:

  • Acute asthma attack unresponsive to prescribed therapy

  • Anaphylaxis (life-threatening allergic reaction)

  • Epiglottitis (life-threatening inflammation and swelling of the epiglottis, a tissue flap between the tongue and windpipe)

  • Pulmonary edema (fluid buildup in the lungs)

Questions for diagnosing the cause of wheezing

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your wheezing including:

  • Do you have any other symptoms?

  • What medications are you taking?

  • When did you first notice your wheezing?

  • When do you have the wheezing?

  • Are you coughing up any sputum?

What are the potential complications of wheezing?

Because wheezing can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Adverse effects of treatment

  • Heart failure

  • Progression of symptoms

  • Respiratory arrest

  • Sleep disorder

  • Spread of cancer

  • Spread of infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 21
  1. Asthma. MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000141.htm
  2. Calışkan M, Bochkov YA, Kreiner-Møller E, et al. Rhinovirus wheezing illness and genetic risk of childhood-onset asthma. N Engl J Med 2013; 368:1398.
  3. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
  4. Wheezing. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003070.htm
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