Symptom Finder - Wheezing
WHEEZING
The causes of wheezing may be recalled by following the air passages from the larynx to the alveoli.
Larynx: Laryngitis may obstruct the inspiration of air causing wheezing. This is typically respiratory wheezing, especially with epiglottitis.
Trachea: This brings to mind tracheobronchitis and foreign bodies.
Bronchi: This prompts the recall of bronchitis, bronchiolitis, and bronchial asthma. It should also remind one of pulmonary emphysema, pneumoconiosis, silo-filler’s disease, and bronchogenic carcinoma. Hereditary angioedema may cause wheezing.
Alveoli: This suggests pulmonary edema with associated cardiac asthma.
Approach to the Diagnosis
CBC, chest x-ray, sputum smear, and cultures will help to diagnose infectious causes of wheezing. Bronchial asthma can be diagnosed by sputum for eosinophils and pulmonary function testing. Cardiac asthma (due to CHF) can be diagnosed by a venous pressure and circulation time, BNP, electrocardiogram (EKG) and echocardiography. Bronchoscopy may be necessary if a foreign body is suspected. Hereditary angioedema is diagnosed by a deficiency of C1 esterase inhibitor.
Other Useful Tests
1. Trial of albuterol inhaler(asthma)
2. Trail of diuretics (CHF)
3. High resolution CT scan (COPD, bullous lung disease)
The causes of wheezing may be recalled by following the air passages from the larynx to the alveoli.
Larynx: Laryngitis may obstruct the inspiration of air causing wheezing. This is typically respiratory wheezing, especially with epiglottitis.
Trachea: This brings to mind tracheobronchitis and foreign bodies.
Bronchi: This prompts the recall of bronchitis, bronchiolitis, and bronchial asthma. It should also remind one of pulmonary emphysema, pneumoconiosis, silo-filler’s disease, and bronchogenic carcinoma. Hereditary angioedema may cause wheezing.
Alveoli: This suggests pulmonary edema with associated cardiac asthma.
Approach to the Diagnosis
CBC, chest x-ray, sputum smear, and cultures will help to diagnose infectious causes of wheezing. Bronchial asthma can be diagnosed by sputum for eosinophils and pulmonary function testing. Cardiac asthma (due to CHF) can be diagnosed by a venous pressure and circulation time, BNP, electrocardiogram (EKG) and echocardiography. Bronchoscopy may be necessary if a foreign body is suspected. Hereditary angioedema is diagnosed by a deficiency of C1 esterase inhibitor.
Other Useful Tests
1. Trial of albuterol inhaler(asthma)
2. Trail of diuretics (CHF)
3. High resolution CT scan (COPD, bullous lung disease)
