What is Wheezing?

Wheezing are the continuous adventitious lung sounds that individuals make. It is defined by the American Thoracic Society Committee as "high-pitched continuous sounds with a dominant frequency of 400 Hz or more." The sound can be developed and generated from anywhere between the distal bronchioles and the larynx mostly during exhalation.

Wheezing is considered to be an asymptomatic manifestation of any disease which involves an obstruction of the airways of the individual. In certain cases, wheezing can be audible and does not require a stethoscope to be heard.

What Conditions Is Wheezing A Symptom Of?

Wheezing is a symptom that is most commonly associated with asthma. That being said, it is can also be a symptom of a variety of conditions such as a malignancy of the individual's airways, heart failure, foreign bodies or any lesion that could obstruct the individual's airways. Mentioned below are a few conditions that could include wheezing as a symptom:

1. Asthma
2. Chronic Obstructive Pulmonary Disorder (COPD)
3. Respiratory infections such as laryngitis and croup
4. Vocal cord dysfunction. This includes vocal cord paralysis and paradoxical vocal fold motion
5. Postnasal drip
6. Pulmonary peribronchial oedema.
7. Foreign body inhalation
8. Intrinsic or extrinsic airway compression

What Are The Different Risk Factors When It Comes To Wheezing?

While any individual can experience a wheezing fit, some certain conditions and circumstances put the individual at a higher risk of experiencing wheezing fits. Some of these circumstances are mentioned below:

1. The Sex Of The Individual

   Different studies have been conducted to find out whether males or females are more susceptible to wheezing fits or attacks. As of today, while there is evidence that suggests males are more susceptible to wheezing fits, it is still considered to be inconclusive in nature. That said, in a recent study conducted by Gilbert, it was found that males were more sensitive to aeroallergens as compared to females.

2. The Period Spent Breastfeeding

   Studies have shown that the number of months spent breastfeeding the baby could indicate whether or not the individual is at risk of experiencing a wheezing fit later on in life. A study that was conducted by Micheal Kramer in 2012 showed that 6 months was the optimum time for a baby to be breastfed in order to get protected against respiratory conditions. While it is assumed that the frequency of wheezing fits decreases along with the increase in breastfeeding months, a study conducted by Taveras, showed no difference in the frequency of wheezing fits in children who were breastfed for more than 9 months in comparison to children who were fed for less than 9 months. However, it was also found that children who were breastfed for less than 6 months, not only faced frequent wheezing fits but also were at risk of prematurity and congenital heart disease.

3. Premature Birth

   Children and infants who were born prematurely were found to experience frequent wheezing fits. In addition to this, children and infants with congenital heart conditions experienced more frequent wheezing attacks in comparison to infants without these conditions.

4. Exposure to Cigarette Smoke

   A significant risk factor when it comes to wheezing fits is cigarette smoke. Second-hand smoke is one of the main causes of wheezing and can cause a wheezing attack. It has also been found that a correlation exists between the exposure to second-hand smoke and the duration of the wheezing attack.

5. Atopy and Genetic Tendencies

   Atopy refers to the genetic predisposition that some individuals have, which makes them more susceptible to contracting viruses and experiencing wheezing attacks. Additionally, a history of asthma within the family and a lack of exposure to microbes at a young age can pose as major risk factors for the development of a wheezing fit.

When Is It Important For The Individual To Visit A Doctor?

If the individual experiences a mild wheezing fit caused due to a minor viral infection like a cold, it is probable that the situation will resolve itself with time. That said, it is important that the individual schedules an appointment with the doctor if he or she experiences the following:

1. An accelerated rate of breathing
2. A blue tinge to the skin
3. A difficulty in breathing

It is important that the individual is rushed to the emergency room or ER if he or she experiences the following:

1. The wheezing causes the skin to turn a deep shade of blue and the individual cannot breathe
2. The individual experiences a wheezing fit after he or she is stung by a bee or after they eat something that could inspire an allergic reaction and send the individual into a wheezing fit
3. The individual experiences a wheezing attack when the choke on a piece of food

How Does The Doctor Diagnose An Individual's Wheezing Fit?

To begin with, the doctor will ask the individual a few questions which will give them an idea as to what condition could be. The more prominent questions here are as follows:

1. The duration of each wheezing fit.
2. The frequent of each wheezing attack
3. Whether the wheezing attack was more prominent during the day or during the night?
4. Does it occur during the day to day tasks like eating and washing the clothes or does it occur during more strenuous activities like exercising?
5. Does resting alleviate the wheezing fit?
6. Does the individual wheeze when he or she breathes in and out or do they only wheeze when they either breathe in or out?
7. Does the individual currently smoke or does she have a history of smoking?
8. Does the individual experience wheezing fits after eating certain ingredients or types of food?

Once the answers to all the questions are answered, the doctor may ask the individual to go through a few more tests. The most prominent test that is conducted when the individual first shows signs of wheezing is a chest X-ray. This is done to see if there is any lesion or foreign body present in the airway of the individual. After this, the doctor may try to ascertain a baseline through various pulmonary function tests. This is done with the help of bronchodilator administration. This is generally followed up with an airway challenge test using a bronchoconstriction agent. An example of this would be methacholine. The doctor will then give the individual a temporary treatment and check to see if the wheezing fit gets resolved with the treatment. If there is a reduction in the duration, intensity and frequency of the wheezing fit, the doctor will then cross out a tumour or mass as a likely cause of the individual's wheezing fits. On the other hand, if the individual still experiences the wheezing fit after going through with the treatment, the doctor will conduct a CT scan of the chest along with a bronchoscopy as a tumour or mass may be suspected.