What Causes A Wheeze In Asthma

What Causes An Asthma Attack

An asthma attack can happen when you are exposed to asthma triggers. Your asthma triggers can be very different from someone elses asthma triggers. Know your triggers and learn how to avoid them. Watch out for an attack when you cant avoid your triggers. Some of the most common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, smoke from burning wood or grass, and infections like flu.

Why Am I Wheezing Understanding Common Causes

You have every right to be concerned when something isn’t right with your breathing. A common type of breathing problem is wheezing. Wheezing is a coarse, high-pitched whistling sound that can have various causes. While some cases of wheezing are nothing to be concerned about, there are serious cases of wheezing that need medical attention as well.

What To Do If Your Cat Is Wheezing

If your cat is wheezing after a hairball or an isolated incident of wheezing, this is a chance that they just might need some more water or a way to pass the irritation they are experiencing. If the wheezing persists, you will need to monitor it to see if it worsens over time. If you notice that your cat has been wheezing for an extended amount of time or stressed by it, they need to go to the vet. 

The Dangers Of Asthma

Side effects of uncontrolled asthma can affect your sleep and keep you from breathing well during work or recreation activities. It can also lead to irreversible narrowing of the airways in the lungs and permanent lung damage.

Eyler reports that lung function naturally decreases starting in the mid-30s but uncontrolled asthma can speed up the process. When the lungs arent working normally, the back and neck muscles work harder to try and help the lungs pump air in and out, blood oxygen levels drop, and you become tired more easily.

How To Sleep With Wheezing

People who experience wheezing when lying down may find it difficult to sleep. To improve quality of sleep, people can try:

• Avoiding food before bed: People with GERD should aim to eat at least 23 hours before lying down. This can reduce acid reflux at night, reducing irritation in the esophagus.
• Avoiding caffeine and alcohol: Both caffeine and alcohol make it more likely a person will experience asthma symptoms. Caffeine can also worsen acid reflux.
• Removing allergens: If a person has asthma or bronchitis caused by allergies, identifying and removing allergens that may be present while sleeping could help. For example, if a person allows a pet to sleep on their bed, the dander may cause wheezing at night.
• Trying decongestants: OTC chest decongestants may help with breathing at night, particularly for people with acute bronchitis. Decongestants may also help people with asthma, though some find that they can make symptoms worse.
• Elevating the head: Elevating the head, neck, and shoulders may help to open the airways during sleep, preventing wheezing. It can also reduce acid reflux.
• Keeping medications nearby: Keep medications or inhalers that help with breathing nearby while lying down or sleeping. This allows people to use them as soon as they wake due to wheezing.

It is important for people who regularly wheeze while lying down to seek medical attention. Doctors can help pinpoint the exact cause of the wheezing, and recommend treatments.

Home Remedies For Wheezing

Here are some things you can do at home to help with your wheezing:â

Avoid smoke. If you smoke, you should quit. You should also avoid any sources of second-hand smoke. Smoke can irritate your lungs and inflame your airways.â

Practice deep breathing exercises.Breathing exercises can help you relax your airways. You can try specific types of breathing exercises like pranayama or you can just practice slow, deep breathing. This works best in a moist, humid environment.â

Drink hot tea. The steam and warmth of the tea will help relax your airways. Green tea may have antibacterial properties that can help with infections.â

Use a humidifier.Moist air may help soothe your airways.â

Purify your air. Using an air purifier with a HEPA filter can help get rid of allergens in your home.

What Assessment And Tests May Be Done

Your doctor is likely to ask various questions about the nature of the wheezing and ask if you have any other symptoms. He or she will also examine you. Following a doctor’s assessment, the likely cause may be clear and your doctor will advise on what to do next. Tests may or may not be appropriate.

Many people have repeated episodes of wheezing when the cause is usually clear. For example, people with asthma or COPD.

However, if the cause is not clear, or you are seriously unwell, your doctor may refer you for one or more tests. The tests done can vary depending on the suspected cause . Tests that are commonly done include a chest X-ray and lung function tests.

How Relevant Is This To My Practice

Many preschool children present to the primary care practitioner with recurrent wheeze and cough. These symptoms cause considerable morbidities and can lead to treatment with inhalers, antibiotics or cough mixtures, hospitalisations and considerable healthcare costs.

A clinical diagnosis of asthma is often considered in a child with prolonged cough, particularly if there is associated wheezing and chest tightness. Although asthma is a common cause of cough and wheeze in children and the leading cause of childhood morbidity, episodic cough and wheezing is also common in nonasthmatic children. Although approximately 40% of all young children worldwide have at least one episode of asthmatic symptoms such as wheezing, coughing or dyspnoea, only 30% of preschoolers with recurrent wheezing are eventually diagnosed with asthma at the age of six years.

Explaining Your Symptoms To Your Gp

Its a good idea to start a diary of your symptoms before speaking to your GP. Taking note of when symptoms flare-up may help you to understand your triggers. This diary will then help your GP to understand and properly assess your condition. You could also try filming your symptoms if they are hard to describe.

There are several different tests for asthma – so your GP wont be able to diagnose you straightaway. Our advice on diagnosing asthma explains this process in more detail.

Insect Stings And Medications

Insect stings which cause an allergic reaction are likely to cause wheezing. Wheezing can also be a side effect of certain medicines like aspirin. Do check with your doctor whether any medicine that youre taking can be responsible for making you wheeze.

What to do: If you start wheezing or experience other symptoms like nausea, a fast heart rate, dizziness, trouble swallowing, or confusion after an insect bite do seek immediate medical help as you could be experiencing a severe allergic reaction. Wheezing that occurs immediately after taking a new medicine also needs urgent medical attention.

Enhancing Healthcare Team Outcomes

Wheezing is a common sign encountered in clinical practice by the nurse, primary care provider, internist, cardiologist, and pulmonologist. Evaluation and treatment can be optimized with an interprofessional team. When wheezing is heard, some workup is required because it is an abnormal sound. The first imaging test of choice in a patient with wheezing is a chest x-ray to look for a foreign body or a lesion in the central airway. In the non-acute setting, if asthma is suspected, the next step is to obtain baseline pulmonary function tests with bronchodilator administration. Following this, it may be necessary to perform an airway challenge test with a bronchoconstrictive agent such as methacholine. If the wheezing resolves with a bronchodilation agent, a tumor or mass as the cause is a much less likely consideration. If there is no resolution after a breathing treatment, and a tumor or mass is suspected, then a CT scan of the chest and bronchoscopy may be required if possible malignancy is suspected on CT.

What Causes Wheezing

Wheezing is usually caused by an obstruction or narrowing of the small bronchial tubes in the chest. It can also be caused by an obstruction in the larger airways or vocal cords. The causes range from chronic , usually manageable conditions such as asthma, to very serious conditions that include heart failure. The most common causes of wheezing include problems with your:

Lungs:

• Asthma is a chronic condition that causes spasms and swelling in the bronchial tubes. Wheezing in asthma can be triggered by exposure to airborne allergens such as pollen, mold, animals, or house dust. Viral illnesses can also make asthma symptoms worse.
• Bronchitis is inflammation of the lining of the bronchial tubes.
• Bronchiolitis is most common in young children.
• COPD is chronic obstructive pulmonary disorder, a long-term inflammation and damage of the bronchial tube lining, most commonly from smoking cigarettes.
• Cystic fibrosis . In people who have CF, thick mucus clogs the airways and makes breathing difficult.
• Pneumonia is an inflammation of the lungs caused by a virus or bacteria.
• Respiratory Syncytial Virus is a seasonal lung infection that can lead to bronchiolitis or pneumonia.
• Aspirating a foreign object into the lungs.

Vocal cords:

• Vocal cord dysfunction. VCD causes your vocal cords to close instead of opening up when you breathe in and out, making it harder to get air into or out of your lungs.

The digestive tract:

Allergies:

Heart conditions:

Lifestyle choices:

When To See A Doctor

If a person is wheezing for an unknown reason or thinks that they might have asthma or COPD, they should see a doctor.

Anyone who notices signs of pneumonia, has difficulty breathing, or sees that their skin has turned blue should seek emergency help.

People should also seek emergency medical attention if they are having an asthma attack or have started wheezing after:

• getting an insect sting or bite
• taking medication
• having an allergic reaction

If people have had an anaphylactic reaction, they should seek emergency help immediately, even if they have taken an epinephrine injection and are feeling better.

Anyone with long-lasting or repeat bronchitis infections should see their doctor for treatment.

What Is Recurrent Wheeze And Cough

Although recurrent wheeze and cough are commonly presented to the family physician, there is currently no standard definition for it. Some authors have defined recurrent wheeze as more than one episode of wheeze within the last 12 months and recurrent cough as two or more episodes of cough without a cold in the past year. Guidelines by the American College of Chest Physicians and Thoracic Society of Australia and New Zealand have categorised cough according to duration rather than frequency. Recurrent cough that is frequent with short intervals of resolution is difficult to distinguish from persistent chronic cough.

Less Common Causes Of Chest Wheezing

Not all that wheezes is asthma! While wheezing is just one of the common symptoms of asthma and may be part of symptoms associated with COPD and vocal chord dysfunction, a number of other diseases can be associated with asthma symptoms such as wheezing and cough. Learn about some of the less common conditions that may cause you to wheeze.

What Should I Do If I Am Wheezing

Wheeze is a very common symptom that can occur with a wide range of lung and airways disorders at any age. The severity of the diseases causing wheeze can vary. Typically, other lung or respiratory related symptoms tend to occur at the same time as wheeze. In particular, a cough is common but other more serious symptoms may be present such as breathing difficulty.

Why Do Some People With Asthma Not Wheeze

As we know, asthma comes in many shapes, sizes, and severities. While many people who have asthma do experience wheezing, some do not. The reason, is quite polarized.

There are two reasons why an asthmatic may not wheeze: one is that their asthma exacerbation is improving, the other is that it is getting worse, much worse.1 Ironic, yes, and also a very serious difference. While some experience their wheeze dissipating due to the airways becoming less obstructed by inflammation, others experience a silence from not enough air moving to make a sound. This is where it becomes crucial that medical teams do more than listen for a wheeze; a mistake could be life-threatening.

How Is Asthma Treated

Take your medicine exactly as your doctor tells you and stay away from things that can trigger an attack to control your asthma.

Everyone with asthma does not take the same medicine.

You can breathe in some medicines and take other medicines as a pill. Asthma medicines come in two typesquick-relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. If you need to use your quick-relief medicines more and more, visit your doctor to see if you need a different medicine. Long-term control medicines help you have fewer and milder attacks, but they dont help you while you are having an asthma attack.

Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor about the side effects of your medicines.

Remember you can control your asthma. With your doctors help, make your own asthma action plan. Decide who should have a copy of your plan and where he or she should keep it. Take your long-term control medicine even when you dont have symptoms.

When Should I Go To The Emergency Room

If your skin, mouth or nails are turning blue, then you arent getting enough air into your lungs. This is a medical emergency and you should have a family member or friend take you to the nearest urgent care or emergency room. If youre alone, call 911 and describe your breathing.

If you suddenly start wheezing after a bee sting, after you take a new medication or eat a new food, that could indicate an allergic reaction and you should go to the emergency room immediately.

Whatever the cause of your wheezing, there are things you can do to get relief. Follow your healthcare providers directions, dont smoke, take all medications as prescribed and run a vaporizer or humidifier to moisten the air. Doing all of these things will help you breathe easier.

Last reviewed by a Cleveland Clinic medical professional on 09/24/2020.

References

How Common Is Asthma Wheeze

More than 25% of infants have at least one wheezing episode.2 By age six, nearly 50% of children have had a wheezing episode.

Wheeze that starts in childhood and continues past age three years typically continues into adulthood.5 In fact, research has shown that wheezing that seems to start in adulthood probably has its origins in childhood.5 In one study, 94% of people who went to the emergency room for an asthma flare-up reported wheezing as one of their symptoms.6

How The Treatment Goals Are Attained

Unfortunately, there is no magic bullet for asthma. While treatment can control symptoms safely and effectively for most patients most of the time, it is not a simple matter of the doctor writing a prescription and the patient taking the medication. Successful treatment of asthma is likely to require several steps on the part of physician. These include:

• Confirmation of the diagnosis
• Characterization of the asthma with regard to:
• Chronicity
• Severity
• Identification of triggers
• Identification of the components of airway obstruction

The diagnosis of asthma is suspected when a patient has a history of recurrent or chronic shortness of breath, labored breathing, or cough in the absence of any other obvious reason. The diagnosis is confirmed by obtaining evidence that there is airway obstruction that reverses either spontaneously or as a result of treatment with anti-asthmatic measures. The procedures used to make the diagnosis include a careful history, measurement of pulmonary function , and therapeutic trials of medication.

Triggers of asthma, those identifiable factors that commonly worsen symptoms include:

• Viral respiratory infections ;
• Airborne allergens ;
• Inhaled irritants ;
• Cold air
• Exertion

Patients with an intermittent pattern of asthma require only intervention measures.

What Other Conditions Can Cause Wheeze

Asthma is the most common reason for wheezing in children. Allergies, colds, gastroesophageal reflux disease , and obstructive sleep apnea are other common causes of childhood wheeze.2

In adults, chronic obstructive pulmonary disease and asthma are the main causes of wheeze.4 Other causes include postnasal drip syndrome, infections, congestive heart failure, and obstruction of the windpipe and large airways due to tumors, scarring, or excessive mucus.

Contact Doctor During Office Hours

• Don’t have written asthma action plan from your doctor
• Use an inhaler, but don’t have a spacer
• Miss more than 1 day of school per month for asthma
• Asthma limits exercise or sports
• Asthma attacks wake child up from sleep
• Use more than 1 inhaler per month
• No asthma check-up in more than 1 year
• You have other questions or concerns

What Is The Role Of Wheezing In The Assessment Of Asthma

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Wheezing, a musical, high-pitched, whistling sound produced by airflow turbulence, is one of the most common symptoms. In the mildest form, wheezing is only end expiratory. As severity increases, the wheeze lasts throughout expiration. In a more severe asthmatic episode, wheezing is also present during inspiration. During a most severe episode, wheezing may be absent because of the severe limitation of airflow associated with airway narrowing and respiratory muscle fatigue.

Asthma can occur without wheezing when obstruction involves predominantly the small airways. Thus, wheezing is not necessary for the diagnosis of asthma. Furthermore, wheezing can be associated with other causes of airway obstruction, such as cystic fibrosis and heart failure. Patients with vocal cord dysfunction, now referred to as inducible laryngeal obstruction , have a predominantly inspiratory monophonic wheeze , which is heard best over the laryngeal area in the neck. Patients with excessive dynamic airway collapse , bronchomalacia, or tracheomalacia also have an expiratory monophonic wheeze heard over the large airways. In exercise-induced bronchoconstriction, wheezing may be present after exercise, and in nocturnal asthma, wheezing is present during the night.

References

Is All Asthma The Same

Asthma is quite variable. Symptoms can range from trivial and infrequent in some to severe, unrelenting, and dangerous in others. Even when severe, however, the airway obstruction is usually fully reversible, either spontaneously or as a result of treatment. This means that symptoms can be relieved, airway obstruction can be reversed, and pulmonary function can be made normal.

There are different patterns of asthma. Some people have only an intermittent pattern of disease. They have self-limited episodes of varying severity followed by extended symptom-free periods. The individual episodes are frequently triggered by viral respiratory infections . This is particularly common in young children in whom viral respiratory infections are frequent . Others have these intermittent symptomatic periods brought on by vigorous exertion, cold air, or specific environmental exposures. This pattern is intermittent asthma.

More prolonged periods of symptoms occur in people who have asthma from seasonal outdoor inhalant allergens. This may be from grass pollen on the West Coast or mold spores from molds that grow on decaying vegetation in the Midwest. Through a knowledge of the aerobiology in your area and allergy skin testing, your physician can attempt to identify whether the symptoms fit into this pattern of disease. This pattern is seasonal allergic asthma.

Personal And Family History Of Atopy

Numerous studies have linked family history of atopy and atopic manifestations in the child as risk factors for the development of asthma in preschool children who wheeze.

Maternal asthma was shown to be an independent risk factor for persistent wheezing in the Tucson study. A large population-based Finnish study found maternal asthma to be the strongest predictor of childhood asthma, while a school-based study of Southern Californian children reported that parental and sibling history of asthma and allergy was most strongly associated with the risk of early-onset persistent asthma. Data from a longitudinal study of Australian children also identified maternal asthma, among other factors, as an independent risk factor for the development of asthma during infancy. Other independent risk factors included male gender, young maternal age and maternal smoking during infancy.

The Alspac study found that in children who started wheezing before the age of six months, atopic eczema and parental history of asthma were important risk factors, both for development of wheeze and its persistence beyond six months. Kurukulaaratchy et al reported that the presence of eczema, allergic rhinitis and parental or sibling history of asthma in childhood wheezers conferred significant risk of wheeze persisting until schoolgoing age.

Key clinical signs that suggest an atopic phenotype include the following:

• Atopic eczema or dermatitis

Breathing In A Foreign Object

If a foreign object is inhaled into your nose or respiratory tract it can get stuck and make it difficult for you to breathe. Children between the ages of 1 and 3 are most likely to breathe in foreign objects. Examples of things that might be inhaled include foods like nuts and seeds, and other small objects like buttons, beads, and marbles. This can cause choking, coughing and wheezing. It might also lead to infection and inflammation.

What to do: If your child is having trouble breathing her airways might have become completely blocked and she might need immediate medical attention. And if symptoms like choking and coughing have gone away keep a look out for signs of infection.

Vaping And Lung Damage

• Talk with your teen about the dangers of vaping.
• Vaping can cause severe lung damage. It can become permanent.
• Vaping can even cause death .
• Vaping tobacco also causes nicotine addiction.
• For these reasons, the legal age to purchase vaping products is 21 in the US.
• Encourage your teen to not start vaping or to give it up.
• Warning: home-made or street-purchased vaping solutions are the most dangerous.

How Does A Doctor Diagnose The Cause Of Wheezing

If you visit your doctor with wheezing symptoms, theyll likely begin by giving you a physical exam to rule out possible health conditions. If your doctor finds abnormalities with your lungs and airways, theyll measure how much air moves in and out as you breathe with lung function tests.

Before and after performing pulmonary tests, your doctor will have you take a medication called a bronchodilator that opens up your airways. Theyll use special medical devices that you breathe into to perform the following tests:

• Spirometry. This measures how well your lungs function compared to healthy lungs.
• Peak flow. This test that measures how hard you can breathe out. If your airways are narrowing, this number will be lower than expected.

Additional tests to diagnose the cause of wheezing include:

Your doctor will analyze the results of your tests to arrive at the appropriate diagnosis.

If they suspect you have allergies, your doctor may ask you to keep a detailed diary of the foods you eat, symptoms, and possible allergy triggers other than food. If diagnostic tests suggest you have asthma, your doctor will classify its severity using a symptom-based scale:

Causes Of Wheezing In Babies And Children

Newborns breathe only through the nose, so when they are congested or in the wrong position, they may make a wheezing or squeaking sound.

As long as they are breathing at a normal rate and the chest is not caving in, this is nothing to worry about.

If a babys chest begins caving, they are breathing rapidly, or wheezing is associated with an illness, they should be taken to a doctor or pediatrician.

When the airways narrow due to irritation, illness, or a blockage, air moving through them can make a squeaking sound.

Some people experience other symptoms as well, including discomfort when breathing or a choking sensation.

Causes include:

How Does Asthma Start

Asthma is a lung disease that causes the airways to swell and produce excess mucus when a trigger causes an attack. An asthma attack is characterized by tightness in the chest and difficulty breathing. Some people also experience a dry cough or a wheeze during exhalation.

It can be harder to identify asthma as an adult because sometimes we dismiss our symptoms or associate them with something else, said Mary Jo Eyler, a respiratory therapist and certified asthma educator at Samaritan Albany General Hospital.But ignoring the symptoms is dangerous.

The exact cause of asthma isnt clear, but it is most likely a combination of genetics and environmental triggers like smoke, mold or animal dander or having a cold or the flu.

According to the Asthma and Allergy Foundation of America, women are more at risk for asthma due to hormonal fluctuations like pregnancy and menopause. Those who are allergic to cats or are obese are also at an increased risk.

Having the flu or a bad cold can be enough to set off asthma symptoms for the first time, according to Eyler. If you have a chest cold that hasnt gone away in 10 days or respiratory symptoms leftover from the flu 10 days after your fever is gone, its a good idea to talk to your doctor.