Overview of Wheezing Breaths

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Wheezing is a high-pitched whistling sound when you breathe. It can occur with certain lung and medical conditions, such as asthma and chronic obstructive pulmonary disease (COPD). While common for some people, it can be a sign of a medical emergency.

You can have wheezing without other symptoms, or it may occur alongside other symptoms, such as shortness of breath. A healthcare provider should diagnose the cause of your wheezing so you can get effective treatment.

This article discusses how to identify wheezing and what causes it. It also covers how the causes of wheezing are diagnosed and treated.

woman wheezing
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What Is Wheezing?

Wheezing can occur with inspiration (breathing in) and with expiration (breathing out), though expiratory wheezing is more common. Most people think of asthma when they hear wheezing, but other causes need to be considered, too.

Wheezing usually comes from the bronchial tubes, small airways in the lungs. However, it can also happen with a blockage in the larger airways or conditions involving the vocal cords.

Sometimes people have more than one condition which leads to wheezing.

What Does Wheezing Sound Like?

It's important to know whether the sounds you hear in your lungs are truly wheezing. That's because there are other sounds that can be mistaken for wheezing.

During your physical examination, your healthcare professionals will listen to your lungs for sounds as you breathe.

Your lungs may sound normal with a quiet sound of air flowing in and out, or you can have sounds that indicate a medical problem—such as wheezing crackles, or stridor.

It's important to distinguish wheezing from stridor, another serious symptom that often has a different pitch and is caused by different conditions. Both sounds can be signs of life-threatening medical emergencies.

Wheezing vs. Stridor

Wheezing is often a medium-pitched sound that is loudest during expiration. It has a fairly continuous musical sound including more than one note.

The sound of wheezing is created by a narrowing of the airways. This can be due to swelling or blockage anywhere from the throat down to the smallest airways.

You can mistake stridor for wheezing.

Some differences between the two:

  • Stridor has a sound that is usually monophonic—meaning that only one note is heard rather than a variety of musical notes.
  • Stridor tends to be higher in pitch than wheezing.
  • Stridor occurs predominately during inspiration.
  • Stridor is usually loudest over the front of the neck, whereas wheezing can be loudest over the lungs.

What Causes Wheezing Breaths?

The most common causes of wheezing are asthma and COPD, but there are many potential causes including:

  • Anaphylaxis: This medical emergency is a severe allergic reaction (often due to a bee sting, medications, or eating nuts or shellfish) that causes swelling in the throat.
  • Bronchitis: This can be acute (lasting only a few days) or chronic (lasting weeks to months to years).
  • Bronchiolitis: This is an infection that involves the bronchioles (the smallest airways) and is most common in children. It is often caused by respiratory syncytial virus (RSV).
  • Inhaling (aspirating) a foreign body: Choking can sometimes cause wheezing if an inhaled object does not completely obstruct the airways. Wheezing related to foreign body inhalation is usually localized to one side of the chest.
  • Pneumonia: A lung infection that can be mild or severe.
  • Bronchiectasis: Widening of the airways, often due to childhood infections or cystic fibrosis, is another cause of wheezing. While cystic fibrosis is most commonly diagnosed in early childhood, it is sometimes diagnosed in adulthood.
  • Viral infections: Many viral infections can cause wheezing, especially in children.
  • Lung cancer: Obstruction of the airway by a tumor can lead to a wheezing sound.
  • Heart failure: This can cause fluid to back up in the lungs.
  • Pulmonary embolism: Blood clots in the legs may break off and travel to the lungs, very rarely causing wheezing.
  • Acid reflux: It may not seem obvious, but acid reflux is a fairly common cause of wheezing.
  • Hypersensitivity pneumonitis: Chronic inflammation of the lungs caused by such things as moldy hay and bird droppings may cause wheezing.
  • Medications (especially aspirin)
  • Vocal cord dysfunction: Caused by one or both of the vocal cords closing unintentionally during breathing. This is also known as “vocal cord asthma.”
  • Epiglottitis: A medical emergency marked by symptoms such as fever, drooling, and sitting in an upright position in an attempt to breathe. It's caused by an infection of the epiglottis, a small piece of cartilage attached to the end of the tongue. Epiglottitis often causes stridor that is heard over the neck, but it may also result in wheezing.

Diagnosing Wheezing Breaths

If you have been wheezing or have had a change in symptoms, it is important to see your healthcare professional—even if you have experienced wheezing in the past or have been diagnosed with asthma.

Call for emergency medical help if you are experiencing chest pains, lightheadedness, shortness of breath, have a bluish tint to your lips and skin, or swelling of your face, neck, or lips.

Evaluation

The first thing your practitioner will do is to make sure you are comfortable and stable. In an emergency, medical personnel and technicians begin with "ABC." This stands for airway, breathing, then circulation. It is important to assess these before going on to try to determine what is actually causing the wheezing.

Once you are stable, your medical team will talk to you about your medical history and perform a physical exam.

Some of the questions they may ask you include:

  • When did your symptoms begin?
  • Have you ever had symptoms like this before?
  • Have you choked while eating?
  • Have you been stung by a bee or have you eaten foods that may cause serious allergic reactions, such as shellfish or nuts?
  • Do you have any other symptoms, such as a cough, shortness of breath, chest pain, hives, swelling of your face or neck, or coughing up blood?
  • Is your wheezing worse at night or during the day?
  • Do you have a personal or family history of asthma, eczema, lung diseases, or lung cancer?
  • Do you, or have you ever, smoked?

Your physical examination will usually begin with measurements of your vital signs, oxygen level, and a lung and heart auscultation.

Testing

Tests to evaluate your wheezing and determine a cause will vary depending upon your history and physical examination.

Testing may include:

  • Chest X-ray
  • Spirometry
  • Blood tests, such as a white blood cell count to look for signs of infection
  • Pulmonary function tests
  • CT scan of your chest
  • Bronchoscopy if your healthcare provider is concerned that you may have aspirated (breathed in) a foreign object or that you may have a tumor in or near your airways
  • Laryngoscopy to look at your larynx and vocal cords
  • Allergy testing if your practitioner feels that you have allergies that are causing your airways to spasm

How to Stop Wheezing

Depending on how serious your symptoms are, your healthcare provider will first do what is necessary to make you comfortable and control your symptoms. Since there are many possible causes of wheezing, further treatment will depend on the cause of your wheezing.

The first steps are to ensure you are getting adequate oxygen into your lungs. Oxygen therapy is commonly used. If wheezing is caused by an allergic reaction, injectable epinephrine is often given.

Other treatments will depend upon the underlying causes of wheezing. For example, treatments for asthma will be used to open the airways, whereas a procedure such as a bronchoscopy may be recommended if it's thought that a foreign body could be blocking the airways.

Summary

Wheezing is a high-pitched whistling sound when you breathe. It can be caused by different conditions involving the airways, including asthma and COPD. To diagnose the cause of your wheezing, your healthcare provider will listen to your breathing and may run tests, such as a chest X-ray, spirometry, or blood tests. Treatment will focus on opening the airways or treating any underlying conditions.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Wheezing.

  2. Sarkar M, Madabhavi I, Niranjan N, Dogra M. Auscultation of the respiratory system. Annals of Thoracic Medicine. 2015;10(3):158-68. doi:10.4103/1817-1737.160831

  3. Irwin R. Evaluation of wheezing illnesses other than asthma in adults.

  4. Ramos MB, Botana-Rial M, Garcia-Fontan E, Fernandez-Villar A, Torreira MG. Update in the extraction of airway foreign bodies in adultsJournal of Thoracic Disease. 2016;8(11):3452–3456. doi:10.21037/jtd.2016.11.32

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Additional Reading
  • Harrison's Principles of Internal Medicine, 20th Edition. New York: McGraw Hill Education. Print.

  • Murray and Nadel's Textbook of Respiratory Medicine, 6th Edition. Elsevier.

  • Oo, S., and P. Le Souef. The wheezing child: an algorithm. Australian Family Physician. 44(6):360-4.

By Lynne Eldridge, MD
 Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."