Moby Thesaurus
asthmatic, breathing, breathless, effervescent, errhine, expiratory, fizzling, heaving, hissing, huffing, hushing, inspiratory, nasal, out of breath, panting, pneumonic, puffing, pulmonary, pulmonic, respiratory, rhinal, short-breathed, short-winded, sibilant, sissing, sizzling, sneezy, sniffing, sniffling, sniffly, sniffy, snoring, snorting, snuffling, snuffly, snuffy, sternutatory, stertorous, wheezy, windedEnglish
Verb
wheezing- present participle of wheeze
A wheeze is a continuous, coarse, whistling sound
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.
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.
The causes of wheezing
Common causes of wheezing are:- Asthma
- Chronic obstructive pulmonary disease
- Medication-induced bronchoconstriction
- Pulmonary edema
- Tracheobronchitis, and
- Vocal cord dysfunction
- anaphylaxis
Less common causes of wheezing include:
- Amyloid deposition
- Carcinoid syndrome
- Chondromalacia
- Descending aortic aneurysms
- Postlobectomy bronchial torsion
- Postradiation stenosis
- Tracheo-broncheal tumors
- Tracheal stenosis
- Tracheomalacia
- Aspiration (foreign particles or foods)
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 airway obstruction., 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. Wheezing heard in the inspiratory phase on the other hand 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. Wheezes heard at the end of both expiratory and inspiratory phases usually signify the periodic opening of deflated alveoli, as occurs in some diseases that lead to collapse of parts of the lungs.The location of the wheeze can also be an
important clue to the diagnosis. Diffuse processes that affect most
parts of the lungs are more likely to produce wheezing that may be
heard throughout the chest
via a stethoscope. Localized processes, such as the occlusion of a
portion of the respiratory tree, are more likely to produce
wheezing at that location, whence the sound will be loudest and
radiate outwardly. The pitch of a wheeze does not reliably predict
the degree of narrowing in the affected airway.
A special type of wheeze is stridor. Stridor — the word is
from the Latin, strīdor — is a harsh, high-pitched, vibrating sound
that is heard in respiratory tract obstruction. Stridor heard
solely in the expiratory phase of respiration usually indicates a
lower respiratory tract obstruction, "as with aspiration of a
foreign body (such as the fabled pediatric peanut)." Stridor in the
inspiratory phase is usually heard with obstruction in the upper
airways, such as the trachea, epiglottis, or larynx; because a
block here means that no air may reach either lung, this condition
is a medical emergency.
Diagnosis
1 out of 3 preschool children and 2 out of 3
school children with recurrent wheezing/coughing are allergic. Allergy can be
described as a malfunction of the human immune system causing a
violent reaction against normally harmless substances in our
natural environment. The reaction creates an inflammation which, in
turn, can lead to a variety of symptoms such as wheezing.
Over the last decade allergy has increased
rapidly in the Western world. Today one child in four is allergic.}
Early diagnosis of allergy is important for the development of the
child later in life. There are many patients with symptoms
suggesting eczema,
rhinitis, hay fever,
asthma or wheezing.
Patients with these conditions may have an allergic condition or
other diseases.