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Expiratory and inspiratory wheezing are sounds that the lungs make when a person breathes out or in. Expiratory wheezing occurs when a person breathes out, while inspiratory wheezing happens when they breathe in. Expiratory wheezing means that the wheeze happens on an exhale of breath. Inspiratory wheezing is a wheeze on the inhale.
Wheezing can be either expiratory, inspiratory, or both. Expiratory wheezing is more common and may mean that a person has a mild blockage causing the wheezing. If people have both expiratory and inspiratory wheezing, this may be because their airways are narrower, and it could indicate a more severe issue.
The cause of the wheezing often depends on its location in the airways, for example, whether it comes from the upper airways in the neck or from lower in the chest. Stridor is the term for a specific type of inspiratory wheezing, which can signal that the upper airway has become blocked.
Many different conditions can cause expiratory and inspiratory wheezing. A condition that obstructs the upper airway is more likely to cause an inspiratory wheeze, but it can also lead to expiratory wheezing.
Asthma is a lung condition that can cause wheezing. People with acute asthma may experience both inspiratory and expiratory wheezing or just one of them.
People with asthma may also experience:
- tightness in the chest
- shortness of breath
- coughing
Chronic obstructive pulmonary disease
COPD is a lung condition. The airways of people with COPD become inflamed, which means that less air can flow into and out of the lungs, making breathing difficult.
Alongside wheezing, symptoms of COPD can include:
- shortness of breath
- a blue tinge to the lips or the base of the fingernails
- fatigue
- phlegm
- frequent coughing
Smoking causes roughly 85–90% of COPD cases. Over time, frequent exposure to air pollution and chemical fumes can also cause COPD. A few causes of COPD are genetic.
Vocal cord dysfunction, also called paradoxical vocal fold movement, happens when the vocal cords do not open as they should.
The symptoms can be similar to those of asthma and include:
- a feeling of tightness in the throat
- coughing
- difficulty breathing
- a hoarse voice or changes to the voice
Bronchitis
Respiratory infections, such as bronchitis, can cause wheezing as well as:
coughing that produces mucus
shortness of breath
low fever
chest pain
Acute bronchitis is temporary and can last from a few days to weeks. People with chronic bronchitis have repeat infections that can last for several months.
Pneumonia is an infection of the lungs that causes them to fill with fluid. This fluid can obstruct the airways and cause wheezing. People may also notice that their breathing is shallow or rapid.
Other symptoms can include:
a cough that produces phlegm or, in some cases, blood
fever and chills
feeling confused
chest pain that worsens when breathing deeply or coughing
nausea
Anaphylaxis
Anaphylaxis is a severe allergic reaction to a substance or insect bite. Along with wheezing, people with anaphylaxis may find it difficult to breathe.
Other symptoms of anaphylaxis include:
swollen lips, tongue, or throat
rash or itching
feeling faint or dizzy
stomach pain
Anaphylaxis can be life-threatening, so people should seek emergency medical attention if they experience the symptoms above.
Lung cancer
Lung cancer can cause wheezing, coughing, and shortness of breath. Other signs to look out for include:
fatigue
unexplained weight loss
pain in the chest
coughing blood
a hoarse voice
recurrent infections, such as pneumonia
In severe cases, wheezing can sometimes be a sign of a collapsed airway or occur as a result of the inhalation of toxic smoke or chemicals.