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| |    Is Wheezing a Surefire Sign of Asthma? by Laura Jana, M.D., F.A.A.P. reviewed by Lynn Cates, M.D., F.A.A.P. While wheezing is commonly considered synonymous with asthma, the standard reminder among health professionals is, "All that wheezes is not asthma." Many factors play a role in determining the most likely cause of a child's wheezing, including
The simplest way to describe wheezing is as a whistling sound. Many parents compare it to the noise generated when wind travels through a wind tunnel. In general, the faster the wind is forced through the tunnel, and the narrower the tunnel is, the louder the whistling sound. The same can be said of wheezing. Health professionals who are experienced in listening to wheezing with a stethoscope can determine not only when wheezing is present, but also the type involved, such as "musical," "inspiratory" or "expiratory" (wheezing that occurs while breathing in vs. that which occurs while breathing out), or focal (heard in just one particular location in the chest). They also may be able to discern the quality of the wheeze (for example, if it sounds fine or harsh), and these distinctions can help a physician to pinpoint the cause of a child's wheezing. Common causes of wheezing Asthma: While asthma is a disease that involves narrowing of the airways, which can in turn cause wheezing, it's generally not diagnosed based on a single episode of wheezing, or in a child under the age of one. That said, more than half of children with asthma develop asthma symptoms before the age of five. For a health professional to diagnose asthma, he typically needs to:
Bronchiolitis: Bronchiolitis typically describes the sudden onset--most commonly seen in the winter months--of wheezing in an infant or toddler. Usually it's caused by a virus, making this is a more likely diagnosis when a runny nose, fever, or other symptom of viral infection is present along with the wheezing (as well as if other family members or close contacts are sick). Although the wheezing associated with bronchiolitis can sound the same as that which is symptomatic of asthma, it doesn't generally respond as well to asthma medications. Inhaled foreign object: A foreign object in the lungs can serve to narrow the airway, so it, too, can cause wheezing. Usually this type of wheezing is heard in just one area of the lungs (focal wheeze). Whenever a child wheezes, especially a young child who has never presented this symptom before, it's important to consider if she might have inhaled (aspirated) a foreign object into her lungs (aspirating). Commonly aspirated objects include peanuts, berries, and raisins. If your child starts wheezing after an earlier episode of choking or gagging, be sure to pass this information on to your child's healthcare provider. Also, it's helpful to know that some children wheeze not because they have aspirated objects, but because they aspirate liquids when they drink. Other children may even aspirate stomach acid into their lungs. Anatomic differences: Less commonly, wheezing is caused by variations in anatomy, such as an abnormally floppy upper airway (known as laryngotracheomalacia) sometimes found in infants, or abnormalities in major blood vessels in the chest that compress neighboring airways and cause obstructed air flow. Although these causes are far less likely to be the cause of wheezing, they should still be considered in a child--especially an infant--who has episodes of unexplained wheezing. When congestion masquerades as wheezing It's really not surprising that many parents, when faced with a child who is congested due to a cold, think that the labored breathing they hear is wheezing. But while upper respiratory tract infections are common triggers for asthma, the sound that is often heard is caused not by obstruction or narrowing of the airways, but by the presence of mucus in the upper airways and nose--and therefore is not true wheezing. If you think your child is wheezing, have your child's healthcare provider have a listen.
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