Sibilant rhonchi

Alternative names

Wheezing

Definition

Wheezing is a high-pitched whistling sound produced by air flowing through narrowed breathing tubes, especially the smaller ones deep in the lung. It is a common finding in asthma and chronic obstructive pulmonary disease (COPD).

Considerations

The clinical importance of wheezing is that it is an indicator of airway narrowing, and it may indicate difficulty breathing.

Wheezing is most obvious when exhaling (breathing out), but may be present during either inspiration (breathing in) or exhalation.

Wheezing most often comes from the small bronchial tubes (breathing tubes deep in the chest), but it may originate if larger airways are obstructed or in certain cases of vocal cord abnormalities.

Common Causes

• Asthma
  
• Bronchiectasis
  
• Bronchiolitis
  
• Bronchitis
  
• Gastroesophageal reflux disease
  
• Viral infection, especially in infants younger than 2 years old
  
• Pneumonia
  
• Emphysema (COPD), especially when a respiratory infection is present
  
• Smoking
  
• Insect sting which causes an allergic reaction
  
• Medications (many asthmatics wheeze after taking aspirin)
  
• Inhalation of foreign matter into the lungs
  
• Heart failure (cardiac asthma)
  

Home Care

• Take all of your medications, especially respiratory inhalers, as directed.
  
• Exposure to moist, heated air (such as through a vaporizer or in a hot shower) may help alleviate some symptoms.
  

Call your health care provider if

• Wheezing is occurring for the first time
  
• Wheezing is associated with significant shortness of breath, bluish skin color, or mental status changes
  
• Wheezing is a recurrent, unexplained problem
  
• Wheezing is caused by an allergic reaction to a bite or medication
  

If wheezing is severe or is accompanied by severe shortness of breath, you may have to go directly to the nearest emergency department.