Asthma-Like Symptoms

Asthma is characterized by wheezing, a tight, breathy-sounding struggle to move air in and out of the lungs. Sometimes this can only be heard with the aid of a stethoscope held over the lungs, but often it can be obvious. Wheezing occurs when airways become tight and constricted. People must work to move air in and out of the airways, accentuating the breath sounds. Constriction of the airways can be brief and temporary as with allergic disorders or longstanding and constant as with lung diseases.

Asthma involves the hyperreactivity of the airways, whether from inhaled allergens or from cold air or stress. The airways react excessively; inflammation causes swelling of the bronchial passages and excessive mucus is secreted compounding the problem. The diagnosis is usually straightforward because, when due to asthma, the wheezing is typically episodic and occurs in obvious association with allergen exposure and in those with other symptoms of systemic allergic tendencies. Asthma almost always responds to inhaled steroids and medications. If the wheezing does not fit this pattern, something else may be going on. .

When wheezing is constant, especially in the elderly or in a lifelong smoker, heart and lung diseases may be the cause. Wheezing due to heart and lung diseases does not respond to inhaled steroids. Such diseases can lead to fluid accumulation which increases the pressure in the airways. As with asthma, airflow is impeded and wheezing results. Many people with such diseases will require lifelong oxygen therapy.

When wheezing begins after a simple cold, or a cold that has moved to the lungs, an infection is the most likely cause. Severe bronchitis and pneumonia always involve coughing and some may begin to wheeze as the infected airways become swollen and inflamed. Often the person feels ill, has a fever and is coughing up mucus. Antimicrobial therapies are needed for this kind of wheezing.

Exposure to toxic gases and fumes can cause sudden onset of wheezing. In an otherwise healthy child, aspiration of a foreign body, such as a toddler accidentally inhaling a small toy, can cause sudden wheezing. Vocal cord lesions can cause wheezing that would be associated either with changes to the voice or mild hoarseness. Wheezing that is occurring from only one location in the lungs suggests a lung lesion or tumor. A doctor should be consulted to diagnose the cause of asthma-like wheezing. Pulse oximetry, chest x-rays, blood gas tests and spirometry can all help diagnose the condition if the presentation is confusing.