Wheezing is a high-pitched, whistling sound usually heard when breathing out. It indicates narrowing or obstruction of the airways. Causes can range from temporary infections to chronic or life-threatening conditions.
1. Lower Airway Obstruction (Most Common Cause):
Asthma – the classic cause: airway inflammation and muscle tightening cause episodic wheezing, especially at night or with triggers like dust, cold, or exercise.
COPD (Chronic Obstructive Pulmonary Disease) – chronic wheezing in older adults, worsens with infections.
Bronchiolitis (in infants) – viral inflammation of small airways causes wheeze, often seasonal.
Bronchiectasis – damaged, mucus-filled airways lead to turbulent airflow and wheeze.
Post-infectious airway hyperreactivity – some people continue to wheeze after recovering from a respiratory infection.
2. Upper Airway Obstruction (Less Common, But Serious):
Foreign body aspiration – especially in children or elderly; sudden wheeze, often on one side.
Tumors or vocal cord dysfunction – growths in or near the upper airways can mimic asthma-like wheeze.
Tracheomalacia or bronchomalacia – weak or floppy airway walls that collapse during breathing.
Stridor (a harsh sound on inspiration) may be confused with wheeze, but it usually indicates upper airway involvement.
3. Cardiac (Cardiac Asthma):
Left-sided heart failure can cause fluid buildup in the lungs (pulmonary edema), leading to wheezing without actual airway narrowing. This is known as cardiac asthma, but it’s not true asthma.
4. Allergic Reactions & Anaphylaxis:
Severe allergic reactions (e.g., to food, insect stings, or medications) cause sudden wheeze with throat tightness, swelling, and difficulty breathing — a medical emergency.
5. Infections:
Viral respiratory infections (e.g., RSV, rhinovirus) often trigger wheeze in children.
Pneumonia can sometimes cause wheezing, especially in children.
Tuberculosis or fungal infections may rarely cause wheezing if they narrow airways.
6. Others / Rare Causes:
GERD (acid reflux) – stomach acid can irritate the airway and mimic wheezing (especially at night).
Medication side effects – such as aspirin-induced asthma or beta-blockers in sensitive individuals.
Anxiety or hyperventilation – can sometimes cause a sensation of wheezing or audible breathing.
Vocal cord dysfunction (VCD) – confused with asthma, but caused by abnormal vocal cord movement.
Duration & Pattern
Sudden wheeze: Think foreign body, anaphylaxis, and asthma attack.