Some Causes and Features of Wheezing
Cause |
Common Features* |
Tests† |
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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 |
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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 |
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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:
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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 |
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A COPD flare-up |
In middle-aged or older people In people who already have COPD Usually a history of extensive smoking Labored breathing |
A chest x-ray |
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Drugs (such as ACE inhibitors, beta-blockers, aspirin, and other NSAIDs) |
In people who have recently started using a new drug, most often in those with a history of airway obstruction (as occurs in asthma) |
A doctor's examination |
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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 |
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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 drugs 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 |
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Usually 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 |
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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 |
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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 |
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* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. |
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† 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. |
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ACE = angiotensin-converting enzyme; COPD = chronic obstructive pulmonary disease; CT = computed tomography; GERD = gastroesophageal reflux disease; NSAIDs = nonsteroidal anti-inflammatory drugs. |
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