A wheeze is a clinical symptom of a continuous, coarse, whistling sound produced in the respiratory

airway The respiratory tract is the subdivision of the respiratory system involved with the process of conducting air to the alveoli for the purposes of gas exchange in mammals. The respiratory tract is lined with respiratory epithelium as respiratory ...

s during breathing. For wheezes to occur, part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract in an asthmatic attack), or airflow velocity within the respiratory tree must be heightened. Wheezing is commonly experienced by persons with a

lung disease The lungs are the primary organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the backbone on either side of the heart. Their function in the respiratory syst ...

; the most common cause of recurrent wheezing is

asthma Asthma is a common long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wh ...

, though it can also be a symptom of

lung cancer Lung cancer, also known as lung carcinoma, is a malignant tumor that begins in the lung. Lung cancer is caused by genetic damage to the DNA of cells in the airways, often caused by cigarette smoking or inhaling damaging chemicals. Damaged ...

congestive heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF typically pr ...

, and certain types of

heart disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina pectoris, angina, myocardial infarction, heart attack), heart failure, ...

s. The

differential diagnosis In healthcare, a differential diagnosis (DDx) is a method of analysis that distinguishes a particular disease or condition from others that present with similar clinical features. Differential diagnostic procedures are used by clinicians to di ...

of wheezing is wide, and the reason for 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 term "wheeze" is also used as a clinical condition describing wheezing in preschool children, termed as "preschool wheeze".

Clinical symptom

Wheeze

Wheezes occupy different portions of the

respiratory The respiratory system (also respiratory apparatus, ventilatory system) is a biological system consisting of specific organs and structures used for gas exchange in animals and plants. The anatomy and physiology that make this happen varies gr ...

cycle depending on the site of airway obstruction and its nature. The fraction of the respiratory cycle during which a wheeze is produced roughly corresponds to the degree of airway obstruction. Bronchiolar disease usually causes wheezing that occurs in the expiratory phase of respiration. As a rule, extrathoracic airway obstruction produce inspiratory sounds. Intrathoracic major airway obstruction produces inspiratory as well as expiratory sounds. Distal airway obstruction predominantly produces expiratory sounds. The presence of expiratory phase wheezing signifies that the patient's

peak expiratory flow rate The peak expiratory flow (PEF), also called peak expiratory flow rate (PEFR) and peak flow measurement, is a person's maximum speed of exhalation, expiration, as measured with a peak flow meter, a small, hand-held device used to monitor a person's ...

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

tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

s, foreign bodies or scarring. This is especially true if the wheeze is monotonal, occurs throughout the inspiratory phase (i.e. is "holoinspiratory"), and is heard more proximally, in the

trachea The trachea (: tracheae or tracheas), also known as the windpipe, is a cartilaginous tube that connects the larynx to the bronchi of the lungs, allowing the passage of air, and so is present in almost all animals' lungs. The trachea extends from ...

. 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

lung The lungs are the primary Organ (biology), organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the Vertebral column, backbone on either side of the heart. Their ...

s. 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 The thorax (: thoraces or thoraxes) or chest is a part of the anatomy of mammals and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main di ...

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, hence 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.

Stridor

A special type of wheeze is

stridor Stridor () is an extra-thoracic high-pitched breath sound resulting from turbulent air flow in the larynx or lower in the bronchial tree. It is different from a stertor, which is a noise originating in the pharynx. Stridor is a physical sig ...

. 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 inspiratory phase of respiration usually indicates an upper 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. Biphasic stridor (occurring during both the inspiratory and expiratory phases) indicates narrowing at the level of the

glottis The glottis (: glottises or glottides) is the opening between the vocal folds (the rima glottidis). The glottis is crucial in producing sound from the vocal folds. Etymology From Ancient Greek ''γλωττίς'' (glōttís), derived from ''γ ...

or subglottis, the point between the upper and lower airways.

Preschool wheeze

Preschool wheezing is a clinical condition that describes wheezing preschool children that do not fulfill the criteria of "

" fully as asthma would require a person to demonstrate a history of at least three episodes of exacerbations (worsening of symptoms) or chronic cough or wheeze for the past six months. Besides, a number of wheezing preschool children would have their symptoms resolved after they had grown up, unlike asthma which persists into adulthood. Preschool wheezing can be divided into "viral-induced wheeze" and "multi-trigger wheeze". Viral-induced wheezing accounts for about two-thirds of all preschool wheezes. The wheezing symptom is episodic and the child is completely normal in between wheezing episodes. It has a good prognosis and only supportive treatment is required. Meanwhile, multi-trigger wheezing is associated with allergy and a family history of asthma. Symptoms occur in between wheezing episodes and are likely to persist beyond early childhood. Due to difficulty in differentiating both types of wheeze, the diagnosis of viral-induced versus multi-trigger wheeze may be delayed for a period of time until its clinical course has become clear.

To wheeze (slang)

To wheeze implies an inability to speak clearly, so in politics it refers to an unorthodox or less than

ethical Ethics is the philosophical study of moral phenomena. Also called moral philosophy, it investigates normative questions about what people ought to do or which behavior is morally right. Its main branches include normative ethics, applied e ...

maneuver that is not actually illegal, but relies on an element of deception or sleight of hand, being an intermediate between a

workaround A workaround is a bypass of a recognized problem or limitation in a system or policy. A workaround is typically a temporary fix that implies that a genuine solution to the problem is needed. But workarounds are frequently as creative as true so ...

and a

scam A scam, or a confidence trick, is an attempt to defraud a person or group after first gaining their Trust (emotion), trust. Confidence tricks exploit victims using a combination of the victim's credulity, naivety, compassion, vanity, confidence ...

. In this context ''wheezing'' is notably linked with the slang expression ''Joe Blow'' meaning any external person or group beyond a secretive

fraternity A fraternity (; whence, "wikt:brotherhood, brotherhood") or fraternal organization is an organization, society, club (organization), club or fraternal order traditionally of men but also women associated together for various religious or secular ...

.Vocabulary.com: Joe Blow Accessed 02 July 2024
/ref> (See also

insider trading Insider trading is the trading of a public company's stock or other securities (such as bonds or stock options) based on material, nonpublic information about the company. In various countries, some kinds of trading based on insider informati ...

References

External links

Audio Breath Sounds
- Multiple case studies with audio files of lung sounds.

- sound files of breath sounds {{Circulatory and respiratory system symptoms and signs Symptoms and signs: Respiratory system