Abnormal Breath Sounds

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Introduction

Breath sounds, also called lung sounds, are the noises that the structures in the lungs make when a person breathes in and out.

The normal sounds that people make when they breathe should hardly be noticeable.

However, abnormal breaths may sound strained, and odd noises may come from the lungs when the person inhales or exhales. These sounds are more apparent with a stethoscope, but some are loud enough to hear with the ears.

Abnormal breathing may be a sign of an underlying issue or medical condition. Infections and other conditions that cause inflammation or fluid buildup in the lungs commonly cause unusual breath sounds.

Types

There are several distinct types of abnormal breath sounds, including:

Crackles: Also called rales, crackles tend to sound like discontinuous clicking, rattling, or bubbling when the person inhales. Crackling breath sounds may sound wet or dry, and doctors might describe them as either fine or coarse.

Wheezing: Wheezing noises are high-pitched and continuous and may sound like a breathy whistle. Sometimes, wheezing can be loud enough to hear without a stethoscope. A squawk is a short version of a wheeze that occurs during inhalation.

Rhonchi: Rhonchi are continuous, lower-pitched, rough sounds that many people compare to snoring.

Stridor: Stridor is a harsh, high-pitched, wheeze-like sound. It occurs in people who have a blocked upper airway, usually when they are breathing in.

Some abnormal breath sounds may also change the sound of a person's voice.

Causes

Problems in the lungs or other airways are generally the cause of abnormal breath sounds. The type of breath sound may be different depending on the underlying condition. Common causes of abnormal breath sounds include:

asthma

acute bronchitis

bronchiectasis, an abnormal widening of the airways in the lungs

chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis an object stuck in the lungs or other airways

pneumonia

interstitial lung disease

pulmonary edema, which may relate to congestive heart failure or end-stage renal disease

Each type of breath sound has specific causes:

Crackles: Crackles commonly happen as a result of fluid accumulation in the lungs. Conditions such as pneumonia or left-sided heart failure may cause this buildup.

Wheezing: Wheezing is a common symptom of conditions that narrow the small airways in the lungs, such as asthma and COPD.

Rhonchi: Rhonchi occur due to conditions that block airflow through the large airways, including the bronchi. There may also be inflammation and fluid in these airways. Conditions such as acute bronchitis and COPD may cause rhonchi.

Stridor: Stridor occurs in people with an upper airway blockage. A blockage may occur if a person breathes in a foreign object, chemical, or other harmful substance. A traumatic neck or chest injury involving the upper airway could result in a blockage too. Stridor can also be a symptom of inflammatory conditions, such as tonsillitis, epiglottitis, or croup (laryngotracheitis).

Diagnosis

A doctor will use a stethoscope to listen to the individual's lungs and air passages as they breathe. This will help to identify the type of abnormal breath sound and narrow down the potential causes.

Some doctors also use other listening tools, such as computerized lung sound analysis.

They may ask about any medication the person is taking or has taken recently. They may also ask when the symptoms began and if anything relieves or provokes them.

It is likely that a doctor will order other tests, including imaging tests such as a plain film X-ray or CT scan to look at the chest structures. They may also order blood tests to check for signs of underlying conditions.

If an infection is present, sputum testing may be necessary to diagnose the cause of abnormal breath sounds. For this test, a person must cough up some sputum, which a doctor will then send to a laboratory to check for infectious germs.

A pulmonary function test may help doctors determine if the airways are blocked or damaged. The test will measure how much air the person inhales and exhales and will show whether or not their breathing function is normal.

Treatment

The treatment for abnormal breath sounds varies depending on the underlying cause and the severity of the person's symptoms.

Infections may require antibiotic therapy or breathing treatments to help open up the airways.

In severe cases, a person may need to stay in the hospital. A case is likely to be severe when there is a serious infection or fluid in the lungs, the person has significant difficulty breathing, or there is a blockage in the airways.

People with chronic conditions may need regular medication and breathing treatments. For instance, people with asthma will often need to carry a rescue inhaler at all times in case of an asthma attack.

When to see a doctor

Anyone experiencing continuous abnormal breathing sounds should see a doctor for a proper diagnosis.

Abnormal breathing sounds often indicate common and treatable disorders. However, they may also be a sign of a more severe underlying condition.

In some cases, abnormal breath sounds can be a medical emergency. People should seek immediate medical attention for abnormal breath sounds or breathing difficulties that are sudden or severe.

It is essential to take anyone who is having problems breathing or who has stopped breathing to the emergency room.

In the emergency room, doctors will look for other signs of emergency conditions, such as:

bending forward and using the abdominal muscles or neck muscles to assist or force breathing

nasal flaring when breathing

the skin turning blue, especially in the lips or face

stridor, which means that the person has an upper airway blockage and may be choking or having an acute allergic reaction.

People should speak to a doctor as soon as they notice abnormal breath sounds. Prompt diagnosis and treatment of the underlying cause will give them the best chance of avoiding further health complications.