Wheezing

Dr. Nabi Darya Vali (AIIMS)MBBS

January 16, 2019

March 06, 2020

Wheezing
Wheezing

What is wheezing?

Wheezing is a high-pitched whistling sound that originates from the lungs while breathing out. It is a common problem in children below five years of age with acute respiratory tract infections or other non-infectious causes. It is a sign of asthma.

What are its main associated signs and symptoms?

Wheezing itself is a symptom. It can be seen with the following accompanying clinical signs and symptoms:

  • Bronchospasm- constricted airways in the lungs
  • Difficulty in breathing
  • Whistling sound while breathing
  • Chest tightness
  • Coughing during night
  • Rapid heart rate
  • Rapid breathing

What are the main causes?

Wheezing occurs due to:

  • Bronchiolitis- inflammation of small airways in the lungs called bronchioles
  • Non-infectious causes include structural or functional respiratory tract abnormalities
  • Viral or bacterial respiratory tract infections
  • Asthma
  • Allergies
  • Gastro-esophageal reflux disease (GERD)
  • Foreign body aspiration
  • Immunodeficiency disease
  • Tumour or malignancies (cancers)
  • Seasonal changes

How is it diagnosed and treated?

The diagnosis of wheezing includes:

  • Physical examination
  • Bronchoscopy
  • Airflow obstruction tests
  • Pulse oximetry readings
  • Chest X-ray
  • High resolution computed tomography (CT scan)
  • Magnetic resonance imaging (MRI)
  • Sweat test
  • Bacteriological sputum studies
  • Viral and mycoplasma antibody levels
  • Immune function testing

Treatment of wheezing depends on the underlying causative factors. It is appropriate to administer beta 2 agonists initially in the form of aerosols. In infants with acute bronchiolitis who have respiratory distress syndrome, supportive oxygen therapy is initiated. Sedatives can exacerbate the respiratory distress syndrome and should be avoided. The therapeutic option for treating a recurrent wheeze is different from the one occurring for the first time. The first-line agents include parenteral or oral corticosteroids in case of recurrent wheeze. Antiviral treatment is often initiated if a respiratory syncytial virus is the suspected cause of infection. Vitamin D is proven to be linked with wheezing. Its deficiency can result in exacerbation of wheezing and supplementation may prove beneficial.

 



References

  1. E. Kathryn Miller et al. Wheezing exacerbations in early childhood: evaluation, treatment, and recent advances relevant to the genesis of asthma . J Allergy Clin Immunol Pract. 2014 Sep-Oct; 2(5): 537–543. PMID: 25213046
  2. Lisa Noble Weiss. The Diagnosis of Wheezing in Children. Am Fam Physician. 2008 Apr 15;77(8):1109-1114. American Academy of Family Physicians.
  3. Yehia M. El-Gamal, Shereen S. El-Sayed. Wheezing in infancy. World Allergy Organization Journal, 2011, 4:21
  4. Kana Ram Jat, Sushil Kumar Kabra. Wheezing in children with viral infection & its long-term effects. Indian J Med Res. 2017 Feb; 145(2): 161–162. PMID: 28639590
  5. Prithi Sureka Mummidi et al. Viral aetiology of wheezing in children under five. Indian J Med Res. 2017 Feb; 145(2): 189–193. PMID: 28639594
  6. Bener A, Ehlayel MS, Bener HZ, Hamid Q. The impact of Vitamin D deficiency on asthma, allergic rhinitis and wheezing in children: An emerging public health problem. J Fam Community Med [serial online] 2014 [cited 2019 Jun 28];21:154-61.

Medicines for Wheezing

Medicines listed below are available for Wheezing. Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.