Sibilant rhonchi

Wheezing is a sign that a person may be having breathing problems. The sound of wheezing is most obvious when exhaling (breathing out), but may be heard when taking a breath (inhaling).

Wheezing most often comes from the small bronchial tubes (breathing tubes deep in the chest), but it may be due to a blockage in larger airways or in those with certain vocal cord problems.

• 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 (particularly aspirin)
• Breathing a foreign object into the lungs
• Heart failure (cardiac asthma)

Take all of your medications, especially respiratory inhalers, as directed.

Sitting in an area where there is moist, heated air may help relieve some symptoms. This can be done running a hot shower or by using a vaporizer.

• 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.

Your doctor will perform a physical examination and ask questions, such as:

• When did the wheezing begin?
• How long does it last?
• Does it occur often? Daily?
• At what time of day does it occur?
• Is it worse at night or in the early morning?
• What does the wheezing sound like?
• Does it make breathing difficult?
• Does it require stopping all physical activity?
• Does it go away without treatment?
• What seems to cause it?
  • Eating certain foods?
  • Taking certain medications?
• Do any of the following things make it worse?
  • Exercise
  • Stress
  • Being around pollens, insects, dust, chemicals (perfumes, cosmetics)
  • Being in cold air
  • A cold or flu
• What helps relieve it?
  • Rest?
  • Medications such as bronchodilators?
• Are any of the other symptoms present?
  • Fever
  • Coughing
  • Swelling of the lips or tongue
  • Panic or confusion
  • Loss of voice
  • Loss of consciousness
  • Bluish color to lips or nails
  • Stuffy nose
  • Puffy, red eyes
  • Insect bite
• Did you have an episode of choking?
• Is there a history of asthma or allergies?
• What medications do you take?
• Have you been around tobacco smoke?
• Have you recently been sick?

The physical examination may include listening to the lung sounds (auscultation). If your child is the one with symptoms, the doctor will make sure he or she did not swallow a foreign object.

Tests that may be done include:

• Chest x-ray
• Pulmonary function tests
• Blood studies, possibly including arterial blood gases

Your doctor may prescribe drugs to relieve narrowing of the airways, such as albuterol.

A hospital stay may be needed if:

• Breathing is particularly difficult
• The person needs to be closely watched by medical personnel
• Medicines need to be given by IV (intravenous line)
• Supplemental oxygen is required