Some Causes and Features of Wheezing
Cause | Common Features* | Tests† |
|---|---|---|
Cough Sometimes symptoms of an upper respiratory infection (such as a stuffy nose) Usually no known history of a lung disorder | A doctor's examination | |
Wheezing that starts suddenly, usually within 30 minutes of exposure to a known or potential allergen such as pollen Often a stuffy nose, hives, itchy eyes, and sneezing | A doctor's examination | |
Usually a history of asthma Wheezing that starts spontaneously or after exposure to specific stimuli (such as pollen or another allergen, an upper respiratory infection, cold, or exercise) | A doctor's examination Sometimes one or more of the following tests:
| |
Bronchiolitis (infection of the lower respiratory tract) | In children under 18 months old Usually occurring from November to April in the Northern Hemisphere Usually symptoms of an upper respiratory infection (such as a stuffy nose and fever) and rapid breathing | A doctor's examination |
A COPD flare-up | In middle-aged or older adults In people who already have COPD Usually a history of extensive smoking Labored breathing | A chest x-ray |
A foreign object that has been inhaled | High-pitched wheezing or cough that starts suddenly in people (typically infants or young children) without any symptoms of an upper respiratory infection, fever, or other symptoms of illness | A chest x-ray or CT of the chest |
GERD with repeated reflux of stomach contents into the lungs (chronic aspiration) | Chronic or recurring wheezing Often burning pain in the chest (heartburn) or abdomen that tends to worsen after eating certain foods, while exercising, or while lying flat A sour taste, particularly after awakening Hoarseness A cough that occurs in the middle of the night or early morning No symptoms of an upper respiratory infection or allergy | Sometimes only a doctor's examination Sometimes use of medications that suppress acid, such as a histamine-2 (H2) blocker or proton pump inhibitor, to see whether symptoms go away Sometimes insertion of a flexible viewing tube into the esophagus and stomach (endoscopy) Sometimes placement of a sensor in the esophagus to monitor acidity (pH) for 24 hours |
Often swelling (edema) of the legs Shortness of breath that worsens while lying flat or that appears 1–2 hours after falling asleep Sounds suggesting fluid in the lungs, heard through a stethoscope | A chest x-ray Sometimes a blood test to measure a substance that is produced when the heart is strained called brain natriuretic peptide (BNP) Sometimes echocardiography | |
Irritants that are inhaled | Wheezing that starts suddenly after exposure to irritants at work (occupational exposure) or inappropriate use of cleaning products | A doctor's examination |
Wheezing while inhaling and exhaling, especially in people with risk factors for or signs of cancer (such as a history of smoking, night sweats, weight loss, and coughing up blood) | A chest x-ray or CT of the chest | |
Medications (such as ACE inhibitors, beta-blockers, aspirin, and other NSAIDs) | Usually in people who have recently started using a new medication, most often in those with a history of airway obstruction (as occurs in asthma) | A doctor's examination |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† Doctors usually measure the oxygen level in blood with a sensor placed on a finger (pulse oximetry). A chest x-ray is usually taken unless the person's symptoms are clearly a flare-up of an already diagnosed chronic disorder. | ||
ACE = angiotensin-converting enzyme; COPD = chronic obstructive pulmonary disease; CT = computed tomography; GERD = gastroesophageal reflux disease; NSAIDs = nonsteroidal anti-inflammatory drugs. | ||