Wheezing as a Respiratory Sound

  • Chapter
  • First Online:
Breath Sounds

Abstract

The auscultation of breathing sounds dates back to the years of Hippocrates and was revolutionized after the invention of the stethoscope by Läennec in 1816. Wheezing was amongst the five different types of respiratory sounds described by Läennec. His original description was “the whistling of little birds”. Interestingly, whereas the roentgenogram when discovered verified the accuracy of the stethoscopic findings in many cases, this was not the case for wheeze. Subsequently the value of wheezing as a clinical finding was confirmed by lung function studies, in particular spirometry. It was more a physics-based approach that allowed the understanding of how wheeze is produced and clinical meaning of the noise.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
GBP 19.95
Price includes VAT (United Kingdom)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
GBP 63.99
Price includes VAT (United Kingdom)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
GBP 99.99
Price includes VAT (United Kingdom)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info
Hardcover Book
GBP 109.99
Price includes VAT (United Kingdom)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Mellis C (2009) Respiratory noises: how useful are they clinically? Pediatr Clin N Am 56:1–17

    Article  Google Scholar 

  2. Grigg J, Silverman M (2006) Wheezing disorders in young children: one disease or several phenotypes? In: Frey U, Gerritsen J (eds) Respiratory diseases in infants and children, vol 37. The European Respiratory Soceity, Sheffield, UK, pp 153–169

    Google Scholar 

  3. Brand PL, Baraldi E, Bisgaard H, Boner AL, Castro-Rodriguez JA, Custovic A et al (2008) Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach. Eur Respir J 32:1096–1110

    Article  CAS  Google Scholar 

  4. Meslier N, Charbonneau G, Racineux J (1995) Wheezes. Eur Respir J 8:1942–1948

    Article  CAS  Google Scholar 

  5. Hull J, Forton J, Thomson AH (2015) Pediatric respiratory medi cine, 2nd edn. Oxford University Press, New York

    Google Scholar 

  6. American Thoracic Society Ad Hoc Committee on Pulmonary Nomenclature (1977) Updated nomenclature for membership reaction. ATS News 3:5–6

    Google Scholar 

  7. Mikami R, Murao M, Cugell DW, Chretien J, Cole P, Meier-Sydow J et al (1987) International symposium on lung sounds. Synopsis of proceedings. Chest 92:342–345

    Article  CAS  Google Scholar 

  8. Pasterkamp H, Brand PL, Everard M, Garcia-Marcos L, Melbye H, Priftis KN (2016) Towards the standardisation of lung sound nomenclature. Eur Respir J 47:724–732

    Article  Google Scholar 

  9. Pasterkamp H, Montgomery M, Wiebicke W (1987) Nomenclature used by health-care professionals to describe breath sounds in asthma. Chest 92:346–352

    Article  CAS  Google Scholar 

  10. Melbye H, Garcia-Marcos L, Brand P, Everard M, Priftis K, Pasterkamp H (2016) Wheezes, crackles and rhonchi: simplifying description of lung sounds increases the agreement on their classification: a study of 12 physicians’ classification of lung sounds from video recordings. BMJ Open Respir Res 3(1):e000136

    Article  Google Scholar 

  11. Sarkar M, Madabhavi I, Niranjan N, Dogra M (2015) Auscultation of the respiratory system. Ann Thorac Med 10:158–168

    Article  Google Scholar 

  12. Rott N (1990) Note on the history of the Reynolds number. Annu Rev Fluid Mech 22:1–11

    Article  Google Scholar 

  13. Osborne S (2006) Airways resistance and airflow through the tracheobronchial tree. In: Schwartzstein R, Parker MJ (eds) Respiratory physiology, a clinical approach. Lippincott Williams & Wilkins, Philadelphia, p 17–23, 8–168

    Google Scholar 

  14. Pfitzner J (1976) Poiseuille and his law. Anaesthesia 31:273–275

    Article  CAS  Google Scholar 

  15. Forgacs P (1969) Lung sounds. Br J Dis Chest 63:1–12

    Article  CAS  Google Scholar 

  16. Gavriely N, Palti Y, Alroy G, Grotberg JB (1984a) Measurement and theory of wheezing breath sounds. J Appl Physiol Respir Environ Exerc Physiol 57:481–492

    CAS  PubMed  Google Scholar 

  17. Gavriely N, Palti Y, Alroy G, Grotberg JB (1984b) Measurement and theory of wheezing breath sound. J Appl Physiol 57:481–492

    Article  CAS  Google Scholar 

  18. Forgacs P (1978a) The functional basis of pulmonary sounds. Chest 73:399–405

    Article  CAS  Google Scholar 

  19. Forgacs P (1978b) Lung sounds. Bailliere Tindall, London

    Google Scholar 

  20. Forgacs P (1967) Crackles and wheezes. Lancet 2(7508):203–205

    Article  CAS  Google Scholar 

  21. Grotberg JB, Davis SH (1980) Fluid-dynamic flap** of a collapsible channel: sound generation and flow limitation. J Biomech 13:219–230

    Article  CAS  Google Scholar 

  22. Charbonneau G, Sudraud M, Racineux JL, Meslier N, Tuchais E (1987) Forced expirations in normal subjects. Is the shape of the flow rate curve related to existence of a wheeze? Chest 92:825–831

    Article  CAS  Google Scholar 

  23. Gavriely N, Kelly KB, Grotberg JB, Loring SH (1987) Forced expiratory wheezes are a manifestation of airway flow limitation. J Appl Physiol 62:2398–2403

    Article  CAS  Google Scholar 

  24. Gavrieli N (1987) Inspiratory wheezes and intrathoracic inspiratory flow limitation. J Appl Physiol 52:1988–1992

    Google Scholar 

  25. Boron WF, Boulpaep EL (2012) Mechanics of ventilation. In: Boron WF (ed) Medical physiology. Elsevier Saunders, Philadelphia, PA, pp 637–641

    Google Scholar 

  26. Jordanoglou J, Pride NB (1968) Factors determining maximum inspiratory flow and maximum expiratory flow of the lung. Thorax 23:33–37

    Article  CAS  Google Scholar 

  27. Mead J, Turner JM, Macklem PT, Little JB (1967) Significance of the relationship between lung recoil and maximum expiratory flow. J Appl Physiol 22:95–108

    Article  CAS  Google Scholar 

  28. Frew AJ, Holgate ST (2009) Respiratory diseases. In: Kumar P, Clark M (eds) Kumar & Clark clinical medicine. Elsevier Saunders, Edinburgh, pp 815–817

    Google Scholar 

  29. Anderson K, Aitken S, Carter R, Macleod JES, Moran F (1990) Variation of breath sound and airway caliber induced by histamine challenge. Am Rev Respir Dis 141:1147–1150

    Article  CAS  Google Scholar 

  30. Beck R, Dickson U, Montgomery MD, Mitchell I (1992) Histamine challenge in young children using computerized lung sound analysis. Chest 102:759–763

    Article  CAS  Google Scholar 

  31. Spence DPS, Bentley S, Evans DH, Morgan MDL (1992) Effect of methcholine induced bronchosconstriction on the spectral characteristics of breath sounds in asthma. Thorax 47:680–683

    Article  CAS  Google Scholar 

  32. Malmberg LP, Sovijarvi ARA, Paajanen E, Piirila P, Haahtela T, Katila T (1994) Changes in frequency spectra of breath sounds during histamine challenge test in adult asthmatics and healthy control subjects. Chest 105:122–132

    Article  CAS  Google Scholar 

  33. Shreur HJW, Vanderschoot J, Zwinderman AH, Dijkman JH, Sterk PJ (1995) The effect of methacholine induced acute airway narrowing on lung sounds in normal and asthmatic subjects. Eur Respir J 8:257–265

    Article  Google Scholar 

  34. Spence DP, Graham DR, Jamieson G, Cheetham BM, Calverley PM, Earis JE (1996) The relationship between wheezing and lung mechanics during methacholine-induced bronchoconstriction in asthmatic subjects. Am J Respir Crit Care Med 154:290–294

    Article  CAS  Google Scholar 

  35. Shreur HJW, Vanderschoot J, Zwinderman AH, Dijkman JH, Sterk PJ (1994) Abnormal lung sounds in patients with asthma during episodes with normal lung function. Chest 106:91–99

    Article  Google Scholar 

  36. Fiz JA, Jane R, Salvatella D, Izquierdo J, Lores L, Caminal P et al (1999) Analysis of tracheal sounds during forced exhalation in asthma patients and normal subjects. Chest 116:633–638

    Article  CAS  Google Scholar 

  37. Pochektova IA, Korenbaum VI (2009). Forced expiratory tracheal noise duration in bronchial obstruction among young men. Numerical description of vesicular and bronchial breath sounds [abstract]. The 34th annual conference of international lung sounds association, Haifa, Israel

    Google Scholar 

  38. Korenbaum VI (2009) Statistical simulation of vortex shedding on bronchial tree bifurcations as mechanism of tracheal forced expiratory wheezes origin healthy subjects [abstract]. The 34th annual conference of international lung sounds association, Haifa, Israel

    Google Scholar 

  39. Dyachenko A, Korenbaum VI, Tagiltsev A (2011) Measurements of forced expiratory noise over trachea and infrascapular region [abstract]. The 36th annual conference of international lung sounds association, Manchester, UK

    Google Scholar 

  40. Gavriely N, Kelly KB, Grotberg JB, Loring SH (1989a) Critical pressure required for generation of forced expiratory wheezes. J Appl Physiol 66:1136–1142

    Article  CAS  Google Scholar 

  41. Beck R, Gavriely N (1990) The reproducibility of forced expiratory wheezes. Am Rev Respir Dis 141:1418–1422

    Article  CAS  Google Scholar 

  42. Gavriely N, Shee TR, Cugell DW, Grotberg JB (1989b) Flutter in flow-limited collapsible tubes: a mechanism for generation of wheezes. J Appl Physiol 66:2251–2261

    Article  CAS  Google Scholar 

  43. Murphy RLH, Holford SK, Knowler WC (1977) Visual lung sound characterization by time-expanded waveform analysis. N Engl J Med 296:968–971

    Article  Google Scholar 

  44. Pasterkamp H, Tal A, Leahy F, Fenton R, Chernik V (1985) The effect of anticholinergic treatment on postexertional wheezing in asthma studied by phonopneumography and spirometry. Am Rev Respir Dis 132:16–21

    CAS  PubMed  Google Scholar 

  45. Sovijara ARA, Dalmasso F, Vanderschoot J, Malmberg LP, Righini G, Stoneman SAT (2000) Definition of terms for application of respiratory sounds. Eur Respir Rev 10(77):597–610

    Google Scholar 

  46. Li S-H, Lin B-S, Tsai C-H, Yang C-T, Lin B-S (2017) Design of wearable breathing sound monitoring system for real-time wheeze detaction. Sensors 17(1):171

    Article  Google Scholar 

  47. Riella RJ, Nohama P, Maia JM (2009) Method for automatic detection of wheezing inlung sounds. Braz J Med Biol Res 42:674–684

    Article  CAS  Google Scholar 

  48. Fakhoury K, Seilheimer D, Hoppin A. Approach to wheezing in children. 2008. http://www.uptodate.com

    Google Scholar 

  49. Cane R, Ranganathan S, McKenzie S (2000) What do parents of wheezy children understand by “wheeze”? Arch Dis Child 82:327–332

    Article  CAS  Google Scholar 

  50. Cane RS, SA MK (2001) Parents’ interpretations of children’s respiratory symptoms on video. Arch Dis Child 84:31–34

    Article  CAS  Google Scholar 

  51. Lowe L, Murray C, Martin L et al (2004) Reported versus confirmed wheeze and lungfunction in early life. Arch Dis Child 89:540–543

    Article  CAS  Google Scholar 

  52. Saglani S, McKenzie SA, Bush A, Payne DN (2005) A video questionnaire identifies upper airway abnormalities in preschool children with reported wheeze. Arch Dis Child 90:961–964

    Article  CAS  Google Scholar 

  53. Kiyokawa H, Greenberg M, Shirota K, Pasterkamp H (2006) Auditory detection of simulated crackles in breath sounds. Chest 119:1886–1892

    Article  Google Scholar 

  54. Bahoura M (1999) Analyse des signaux acoustiques respiratoires: contribution a‘ladetection automatique des sibilants par paquets d’ondelettes. PhD thesis Univ, Univ. Rouen, France

    Google Scholar 

  55. Chuah JS, Moussavi ZK (2004) Automated respiratory phase detection by acoustic means. University of Manitoba Dept of Electrical and Computer Engineering

    Google Scholar 

  56. Earis JE, Cheetham BM (2000) Future perspectives for respiratory sound research. Techniques for respiratory sound analysis. Eur Respir Rev 10:636–640

    Google Scholar 

  57. Sestini P, Renzoni E, Rossi M, Beltrami V, Vagliasindi M (1995) Multimedia presentation of lung sounds as a learning aid for medical students. Eur Respir J 8:783–788

    CAS  PubMed  Google Scholar 

  58. Pasterkamp H, Kraman SS, Wodicka GR (1997) Respiratory sounds, advances beyond the stethoscope. Am J Respir Crit Care Med 156(3 Pt 1):974–987

    Article  CAS  Google Scholar 

  59. Elphick HE, Sherlock P, Foxall G, Simpson EJ, Shiell NA, Primhak RA et al (2001) Survey of respiratory sounds in infants. Arch Dis Child 84:35–39

    Article  CAS  Google Scholar 

  60. Rossi M, Sovijarvi AR, Piirila P, Vannuccini L, Dalmasso F, Vanderschoot J (2000) Environmental and subject conditions and breathing manœuvres for respiratory sound recordings. Eur Respir Rev 10:611–615

    Google Scholar 

  61. Vanuccini L, Earis JE, Helisto P, Cheetham BM, Rossi M, Sovijarvi AR et al (2000) Capturing and preprocessing of respiratory sounds. Eur Respir Rev 10:616–620

    Google Scholar 

  62. Bentur L, Beck R, Shinawi M, Naveh T, Gavriely N (2003) Wheeze monitoring in children for assessment of nocturnal asthma and response to therapy. Eur Respir J 21:621–626

    Article  CAS  Google Scholar 

  63. Welsby PD, Parry G, Smith D (2003) The stethoscope: some preliminary investigations. Postgrad Med J 79(938):695–698

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Fischer HS, Puder LC, Wilitzki S, Usemann J, Bührer C, Godfrey S et al (2016) Relationship between computerized wheeze detection and lung function parameters in young infants. Pediatr Pulmonol 51:402–410

    Article  Google Scholar 

  65. Kompis M, Pasterkamp H, Wodicka GR (2001) Acoustic imaging of the human chest. Chest 120:1309–1321

    Article  CAS  Google Scholar 

  66. Mazic J, Sovilj S, Magjarevic R (2003) Analysis of respiratory sounds in asthmatic infants. Meas Sci Rev 3:11–21

    Google Scholar 

  67. Benedetto G, Dalmasso F, Spagnolo R (1988) Surface distribution of crackles sounds. IEEE Trans Biomed Eng 35:406–412

    Article  CAS  Google Scholar 

  68. Elphick HE, Ritson S, Rodgers H, Everard ML (2000) When a “wheeze” is not a wheeze: acoustic analysis of breath sounds in infants. Eur Respir J 16:593–597

    Article  CAS  Google Scholar 

  69. Beck R, Elias N, Shoval S, Tov N, Talmon G, Godfrey S, Bentur L (2007) Computerized acoustic assessment of treatment efficacy of nebulized epinephrine and albuterol in RSV bronchiolitis. BMC Pediatr 7:22

    Article  Google Scholar 

  70. Jácome C, Oliveira A, Marques A (2017) Computerized respiratory sounds: a comparison between patients with stable and exacerbated COPD. Clin Respir J 11(5):612–620

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kostas N. Priftis .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chatziparasidis, G., Priftis, K.N., Bush, A. (2018). Wheezing as a Respiratory Sound. In: Priftis, K., Hadjileontiadis, L., Everard, M. (eds) Breath Sounds. Springer, Cham. https://doi.org/10.1007/978-3-319-71824-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-71824-8_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71823-1

  • Online ISBN: 978-3-319-71824-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Navigation