Wheezes are continuous, coarse, whistling sounds produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed, or airflow velocity within the respiratory tree must be heightened. Wheezing is commonly experienced by persons with a lung disease; the most common cause of recurrent wheezing is asthma, a form of reactive airway disease. For the aerial route, see Airway (aviation). ...

The differential diagnosis of wheezing is wide, and the cause of wheezing in a given patient is determined by considering the characteristics of the wheezes and the historical and clinical findings made by the examining physician. Differential diagnosis is the process by which a physician utiltizes the scientific method and the skills acquired in medical school, internship, and residency to take a history, examine the patient, and do the appropriate testing to determine the nature and extent of a disease process in a patient. ...

The causes of wheezing

Common causes of wheezing are:

• Asthma
• Chronic obstructive pulmonary disease
• Medication-induced bronchoconstriction
• Pulmonary edema
• Tracheobronchitis, and
• Vocal cord dysfunction

Less common causes of wheezing include: Chronic obstructive pulmonary disease (COPD) is an umbrella term for a group of respiratory tract diseases that are characterised by airflow obstruction or limitation. ... Pulmonary edema is swelling and/or fluid accumulation in the lungs. ... The vocal cords, also known as vocal folds, are composed of twin infoldings of mucous membrane stretched horizontally across the human larynx. ...

• Amyloid deposition
• Carcinoid syndrome
• Chondromalacia
• Descending aortic aneurysms
• Postlobectomy bronchial torsion
• Postradiation stenosis
• Tracheo-broncheal tumors
• Tracheal stenosis
• Tracheomalacia

Amyloid describes various types of protein aggregations that share specific traits when examined microscopically. ... Carcinoid is a potentially malignant tumour that occurs in the mucosa of the lungs and digestive tract and potentially in other organs. ... An aortic aneurysm is a general term for any swelling (dilatation or aneurysm) of the aorta, usually representing an underlying weakness in the wall of the aorta at that location. ... A pneumonectomy (or pneumectomy) is an surgical procedure to remove a lung. ... The trachea (IPA /treikiÉ™/), or windpipe, is a tube extending from the larynx to the bronchi in mammals, and from the pharynx to the syrinx in birds, carrying air to the lungs. ...

Characteristics

Wheezes occupy different portions of the respiratory cycle depending on the site of airway obstruction and its nature. The proportion of the respiratory cycle occupied by the wheeze roughly corresponds to the degree of bronchial obstruction.^1,2 Bronchiolar disease usually causes wheezing that occurs in the expiratory phase of respiration. The presence of expiratory phase wheezing signifies that the patient's peak expiratory flow rate is less than 50% of normal.³ Wheezing heard in the inspiratory phase is often a sign of a stiff stenosis, usually caused by tumors, foreign bodies or scarring. This is especially true if the wheeze is monotonal, occurs throughout the inspiratory phase (ie. is "holoinspiratory"), and is heard more distally, in the trachea. Inspiratory wheezing also occurs in hypersensitivity pneumonitis.⁴ Wheezes heard at the end of both expiratory and inspiratory phases usually signify the periodic opening of deflated alveoli. Respiration can refer to: Cellular respiration, which is the use of oxygen in the metabolism of organic molecules. ... The bronchioles are the first airway branches that no longer contain cartilage. ... Spirometry, the most common of the Pulmonary Function Tests (PFTs), is the measurement of lung function, specifically the measurement of the amount (volume) and speed (flow) of air that can be inhaled and exhaled. ...

References