Wheezing in Adults: What Causes the Whistling Sound and When to Be Seen

What it involves

MedlinePlus describes wheezing as a high-pitched whistling sound during breathing that occurs when air moves through narrowed breathing tubes in the lungs. It says the sound is usually loudest when breathing out, though it can also be heard when breathing in.

Who this is for

• Adults who notice a whistling sound when they breathe, especially at night or with exertion
• Patients who wheeze with a cough, chest tightness or shortness of breath
• Smokers and former smokers whose breathing has changed
• People who wheeze after a bite, sting or new medicine and want to know why

What to expect

• Questions about when the wheezing started, how long it lasts, when it is worse and what may trigger it
• A physical exam that includes listening to your lungs
• Possible tests such as a blood oxygen reading, lung function tests or a chest x-ray, ordered when the findings call for them
• A plan for the likely cause, or a referral if a lung or heart specialist is the right next step

What is happening in the airways

MedlinePlus says wheezing most often comes from the small breathing tubes deep in the lungs, but it can also come from a blockage in larger airways or from certain vocal cord problems. That is why a provider cannot tell the cause from the sound alone. Two people can wheeze for completely different reasons, and the pattern matters: whether it is constant or comes in episodes, whether it is worse at night, after exercise or around certain smells, and whether you also have a cough or a fever.

Common causes, as MedlinePlus lists them

The MedlinePlus encyclopedia names asthma, bronchitis, bronchiolitis, bronchiectasis, chronic obstructive pulmonary disease, acid reflux disease, heart failure, pneumonia, smoking, an inhaled foreign object, an allergic reaction to an insect sting, and certain medicines such as aspirin. Our guides to asthma symptoms, COPD symptoms and acute bronchitis describe three of the most common, and each explains what a visit involves.

What a first visit looks like

MedlinePlus says the provider will do a physical exam and take your history, with questions about when it started, how long it has lasted, when it is worse and what might have caused it. The exam includes listening to the lungs. Tests that may follow include blood tests, a chest x-ray, lung function tests and pulse oximetry to measure the oxygen in your blood. At Serenity By A Dr. Sareen the visit covers the history, the exam and blood work, and any imaging or breathing tests are ordered as referrals when needed.

Things you can do at home

MedlinePlus advises taking all of your medicines as directed, and says sitting in an area with moist, heated air, such as a bathroom with a hot shower running, may relieve some symptoms. If you smoke, the quitting smoking guide explains where to start, since smoking is on the list of causes. Keep a short log of when wheezing happens, because a pattern tied to bedtime, exertion, a pet or a food gives your provider a lead that no test can match.

When to book a visit

MedlinePlus says to contact your provider if wheezing occurs for the first time, keeps occurring without explanation, comes with significant shortness of breath, bluish skin, confusion or changes in mental status, or is caused by an allergic reaction to a bite or a medicine. New wheezing at any age deserves a visit rather than a wait to see if it goes away. If the wheezing started after starting a new prescription, mention the date, because medicines are on the list of causes.

When wheezing is an emergency

MedlinePlus says that if wheezing is severe or occurs with severe shortness of breath, you should go directly to the nearest emergency department. Wheezing together with swelling of the lips or face, hives after a sting or a new medicine, or trouble speaking in full sentences can be an allergic emergency, and chest pain with breathlessness needs 911. The shortness of breath guide describes the warning signs in more detail.

Sources

• MedlinePlus: Wheezing (medical encyclopedia)
• MedlinePlus: Asthma (health topic)