How to Spot the Signs of Wheezing

What is wheezing?

Wheezing is a high-pitched whistling sound that comes from the lungs when breathing. It is generally a sign that the airways in the lungs are narrowed.

Doctors can hear wheezing with a stethoscope placed on the chest to listen to the lungs. When it’s severe, it can sometimes be heard without a stethoscope.

Air normally travels through your breathing tube (trachea) and into smaller airways that pull air deep into the lungs. When these airways narrow, wheezing can occur.

Wheezing most often occurs with asthma and chronic obstructive lung disease (COPD) but it can also happen with viral infections (bronchitis), heart failure, and exposure to irritants like allergens or chemicals.

New mild wheezing from a viral infection will improve as your body clears the infection. More chronic wheezing is likely caused by a chronic disease and will improve when you get the underlying disease under control.

Wheezing vs stridor

Wheezing can be confused with stridor. While wheezing is from obstruction of the lower airways deep in the lungs, stridor is from obstruction of the upper airways. It is a high-pitched sound that can often be heard without a stethoscope and usually comes from the neck area.

Other differences: Stridor is often heard more when inhaling, while wheezing is heard more when exhaling. And stridor is often a single constant pitch sound where wheezing is more musical with multiple pitches.

1. Asthma

Symptoms

• Wheezing
• Cough
• Shortness of breath
• Chest tightness

People with asthma have episodes of airway constriction that cause wheezing and shortness of breath. Asthma is more common in people with allergies to environmental allergens (dust, pollen, etc.) and in people who have family members with asthma, according to the CDC.

Inhalers and other medications can help control asthma. Your doctor can help you create an asthma plan for prevention and treatment of your asthma. Uncontrolled asthma can lead to an asthma attack. This is severe shortness of breath and wheezing that can be a life-threatening medical emergency.

2. Acute bronchitis

Symptoms

• Cough, with or without mucus
• Wheezing
• Mild or no fever
• Chest discomfort, tightness, or pressure

Acute bronchitis is an inflammatory reaction in the airways. Usually, a viral infection is the cause, although sometimes the culprit is a bacterial infection. Acute bronchitis often develops after a cold and goes away within 1 to 2 weeks. Bronchitis can also be chronic and is common in current or former tobacco smokers (they may develop chronic obstructive pulmonary disease.

Treatment of acute bronchitis includes cough suppressants, acetaminophen or ibuprofen (for fever or pain), and possibly an inhaler for wheezing. Doctors may prescribe antibiotics, if a bacterial infection is suspected.

3. Chronic obstructive pulmonary disease (COPD)

Symptoms

• Shortness of breath
• Cough, often with phlegm
• Wheezing
• Chest tightness

Chronic obstructive pulmonary disease (COPD) is an obstruction of the airways of the lungs and a breakdown of the air sacs of the lungs. COPD makes breathing difficult.

It is caused by long-term exposure to smoke, usually from cigarette smoking, according to the American Lung Society. Symptoms may take years to develop and may come and go.

COPD can’t be cured, but quitting smoking can stop the ongoing damage to the lungs. Treatment can help reduce symptoms. It includes inhalers, steroids, antibiotics, and pulmonary rehabilitation.

Other possible causes

Here are other conditions that may also cause wheezing:

• Heart failure, if the blood backs up from the heart, and the lungs become too wet
• Severe allergic reactions (anaphylaxis)
• Inhaled foreign bodies, such as a peanut that accidentally gets stuck in the lungs
• Cystic fibrosis, a genetic lung disease that you are born with

When to call the doctor

If you are experiencing wheezing and shortness of breath, see a doctor right away unless you have a known lung disease (e.g., asthma) and already have medication and a treatment plan to try at home.

A doctor should also evaluate persistent wheezing. If it develops after having a cold and cough, it is probably viral bronchitis that will improve in several days to a couple of weeks, but a physician can prescribe you an inhaler to ease your symptoms.

Should I go to the ER for wheezing?

You should go to the emergency department if you have any of these signs of a more serious problem:

• Difficulty breathing
• Shortness of breath
• Rapid breathing
• Difficulty speaking
• Change in voice pitch
• Chest pain

Symptoms that could be anaphylaxis (severe allergic reaction) and needs urgent care include:

• Skin: hives, itching, swelling of lips
• Throat: itching, feeling like throat is closing
• Neurologic: anxiety, dizziness, confusion
• Cardiovascular: chest pain, rapid heart rate, low blood pressure
• Gastrointestinal: nausea, vomiting, diarrhea, abdominal pain

Treatments

At-home care

• If your wheezing is caused by your asthma or COPD, follow the treatments you’ve been prescribed, such as taking your inhaler as needed.
• Quit smoking (or vaping).
• Avoid inhaling irritants like cigarette smoke.
• Get some fresh air if your wheezing is from an indoor irritant like dust, pet dander, or a fragrance.

Other treatment options

• Wheezing will generally improve with treatment of the underlying condition.
• If your wheeze is from a foreign body that is in your airways, you may need to have a procedure called a bronchoscopy to remove that object.
• If you are not getting enough oxygen to your blood, the doctor will give you supplemental oxygen.
• If your wheezing is caused by a bacterial infection, you may be given antibiotics.
• In very rare circumstances, surgery may be necessary to help with the symptoms of chronic lung disease or obstructing lesions.

Here are some over-the-counter options that might help:

• Bronchodilators : These can help to quickly open your airways and relieve wheezing, especially if you're dealing with asthma or COPD.
• Anti-inflammatory Medications: For inflammation that could be contributing to wheezing, OTC non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can be helpful.
• Allergy Medications: If allergens might be the cause, antihistamines could reduce your reaction and ease wheezing.