What is wheezing?

Causes and Symptoms

Wheezing is a whistling or grating noise created when a person’s breathing passages are narrowed or blocked. It can be accompanied by tightness in the chest or shortness of breath, as well as anxiety due to difficulty breathing.

Wheezing is a symptom of several disorders. The most common causes of chronic wheezing are asthma and emphysema. Temporary wheezing due to obstruction by mucus can be caused by bronchitis, pneumonia, viral infections, and allergies as well as smoking and inhalation of fumes or foreign matter. The exact timing of the wheeze can give clues to its cause. Bronchitis causes a noise at the very end of a complete exhalation. Wheezing at the start of exhalation usually indicates asthma or emphysema. Wheezing only when inhaling is a sign of asthma.

Conditions such as gastroesophageal reflux disease, vocal cord dysfunction, and genetic disorders that affect the lungs, such as cystic fibrosis, can also cause wheezing. Patients with heart failure often develop cardiac asthma caused by a pulmonary edema, in which fluid builds up in the lungs because of inefficient pumping of the heart. Less commonly, wheezing may be a symptom of tumors, joint disorders, or heart aneurysms. Radiation therapy for cancer or other diseases can also cause the airways to constrict.

Treatment and Therapy

Treatment for wheezing involves treating the underlying disorder. Doctors may do blood work or administer x-rays; antibiotics and antihistamines may be prescribed for allergies or infections.

Medicines are often given to manage the discomfort and anxiety this symptom causes. For chronic wheezing, respiratory inhalers are usually prescribed. Bronchodilators give temporary relief by relaxing the airways. Bronchodilators can cause dependence, however, and patients should be monitored continually by a doctor. More severe symptoms may require regular use of corticosteroid inhalers, which reduce inflammation in the airways and make them less likely to constrict.

For mild wheezing, drinking warm liquids and inhaling moist, heated air, such as from a vaporizer or a hot shower, is helpful. Severe wheezing may require hospitalization and use of a strong bronchodilator, an oxygen tent, or a respiratory tube.

Perspective and Prospects

The Western use of bronchodilators for treatment of bronchitis and asthma began in the nineteenth century, although Indian medicine had used plant derivatives for similar effect for thousands of years. Corticosteroids became standard treatment during the 1970s.

Although wheezing is a well-managed symptom, determining the precise cause is often extremely difficult. This is especially true for doctors with limited resources in developing countries, where pneumonia is the most common respiratory cause of child mortality.

Bibliography

Barnes, Peter J., and Simon Godfrey. Asthma and Wheezing in Children. New York: Taylor & Francis, 1999.

Carson-DeWitt, Rosalyn. "Asthma—Adult." Health Library, September 30, 2012.

Shuman, Jill. "Bronchitis." Health Library, June 24, 2013.

Silverman, Michael, ed. Childhood Asthma and Other Wheezing Disorders. New York: Oxford University Press, 2002.

"Wheezing." MedlinePlus, May 16, 2010.