Wheezing

Description, Causes and Risk Factors:ICD-10: R06.2Alternative Name: Sibilant rhonchi.Wheezing is a high-pitched whistling sound associated with labored breathing. Wheezing occurs when a child or adult tries to breathe deeply through air passages that are narrowed or filled with mucus. Wheezing is most common when exhaling. It is sometimes accompanied by a mild sensation of tightness in the chest. Anxiety about not being able to breathe easily can cause muscle tension that makes matters worse.Types:
  • During expiratory wheezing, the whistling sound is made when exhaling. This type of wheezing may be present with other symptoms such as cough or shortness of breath. Expiratory wheezing is likely to indicate respiratory disease. Examples include asthma, COPD and pneumonia.
  • Wheezing on exertion occurs during strenuous activities. It can be the result of pulmonary heart disease. In pulmonary heart disease, there is decreased blood flow to the lungs, causing difficulty breathing. Wheezing on exertion can also be caused by exercise-induced asthma. Individuals suffering from exercise-induced asthma are often symptom free when at rest.
Causes and Risk factors may include:
  • Asthma.
  • Exposure to allergens (food, pollen, and other substances, that cause a person to have an allergic reaction).
  • Fumes.
  • Breathing a foreign object into the lungs.
  • Bronchiectasis.
  • Bronchiolitis.
  • Bronchitis.
  • Emphysema (COPD), especially when a respiratory infection is present.
  • Gastroesophageal reflux disease (GERD).
  • Heart failure (cardiac asthma).
  • Insect sting that causes an allergic reaction.
  • Pneumonia.
  • Smoking.
  • Viral infection, especially in infants younger than age 2.
Symptoms:The symptoms of wheezing include a musical or whistling sound and labored breathing, particularly when exhaling; sometimes accompanied by a feeling of tightening in the chest. You can hear wheezing more loudly if you plug your ears and exhale rapidly, or by using a stethoscope held at the neck or over the lungs.On the other hand, stridor is a wheezing and gasping sound heard during inhalation, and usually caused by narrowing of the windpipe or vocal cords (in the neck).Diagnosis:Your PCP will perform a physical examination and ask questions about your medical history and symptoms. The doctor will listen to your lungs with a stethoscope to hear where the wheezing is and how much wheezing you have.Your PCP will probably ask you to perform a breathing test (spirometry) and may also order a chest X-ray. A pulmonary function test may be ordered to measure the amount of air moving through the patient's breathing passages.If it seems like allergies may be related to your wheezing, there are a variety of other tests your PCP may use to verify allergies, including skin testing and blood tests (an eosinophil count or IgE levels).Treatment:Treatment is generally based on the cause.If wheezing is caused by asthma, your doctor may recommend some or all of the following to reduce inflammation and open the airways:
  • A fast-acting bronchodilator inhaler.
  • An inhaled corticosteroid.
  • A long-acting bronchodilator.
  • An asthma controller pill to reduce airway inflammation.
  • A non-sedating antihistamine pill (such as loratadine), or a prescription nasal spray if you have nasal allergies.
If you have acute bronchitis, your doctor may recommend some or all of the following:
  • A bronchodilator (such as albuterol or salbutamol) to help ease the wheezing as the infection clears.
  • An antibiotic if you have an underlying lung problem.
  • Generally, any mild wheezing that accompanies acute bronchitis disappears when the infection does.
When the wheezing symptoms are so severe that a patient is practically suffocating, there are some emergency treatment methods which includes epinephrine shots, supplying oxygen, administration of corticosteroids, use of ventilators and frequent nebulizer use.Certain yoga positions (Bridge, Cobra, Pigeon, and Sphinx) may relieve wheezing by improving breathing control and reducing stress. Patients whose wheezing is related to asthma, chronic bronchitis, emphysema, or a severe allergic reaction may benefit from these techniques, but must continue to have their condition monitored by a conventional physician.Mild wheezing caused by infection or acute illness usually disappears when the underlying cause is eliminated.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 

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