WHEEZING
WHEEZING: Excerpt from Algorithmic Diagnosis of Symptoms and Signs
Wheezing is classically due to bronchial asthma, but there is a danger in jumping to that conclusion because it occurs in a few other conditions as well. The wheezing of bronchial asthma is heard primarily on expiration, whereas the wheezing of tracheal or laryngeal obstruction is heard on inspiration, such as tracheobronchitis in children. The wheezing of cardiac asthma (in
congestive
heart
failure
with acute pulmonary edema) is associated with pink, frothy sputum, whereas the sputum of bronchial asthma is thick and tenacious. Acute infectious bronchitis may simulate bronchial asthma, but the response to epinephrine is poor. This is true also of pulmonary emphysema, but the history will usually differentiate this condition from bronchial asthma. A foreign body may often be distinguished because the wheezing is unilateral.
DIAGNOSTIC WORKUP
The CBC, sedimentation rate, chest x-ray, EKG, sputum analysis and culture, and pulmonary function testing will usually assist with the clinical diagnosis. Bronchoscopy may be needed also, especially when there is hemoptysis
.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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