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Difficulty breathing (Breath Sounds)

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Difficulties in breathing can be felt in the form of secondary breathing and respiratory distress, which occur during inhalation and / or exhalation. Find out more about causes and therapies here.

Breathing difficulties come in a variety of forms and gradations. They are noticeable as conspicuous breathing noise (referred to by physicians as secondary breath sounds called rattling noises, whistling or wheezing), which, depending on the cause, can occur both during inhalation and exhalation and can be associated with the feeling of not getting enough air. This can be increased to total breathlessness .

Depending on the cause of the breathing difficulties, other symptoms, such as coughing , hoarseness, sputum and chest pain, may sometimes appear in connection with breathing difficulties and breathing sounds .

The causes of breathing difficulties

Morbid breathing sounds occur when breathing is impeded by mucus or fluid in the airways. Since the respiratory sounds can originate from the lung (Latin: pulmo) itself or from the pleura, a distinction is made between pulmonary and pleural secondary respiratory sounds:

  • Secondary breath sounds (pulmonary breath sounds) and
  • wet breath sounds (rattle noise).

They are produced by low-viscosity secretions, such as edema fluid in inflammation. According to their character, the following forms of wet rattle noise are distinguished, which go back to different causes:

  • Coarse bubble rattle sounds: occur in large-diameter lung sections; Possible causes: pulmonary edema
  • Middle-bubbled rattling noises: occur in lung sections of medium diameter; Possible cause: bronchitis
  • Fine-bubble rales: occur in small-diameter lung sections, ie near the alveoli; Possible cause: pneumonia

Another distinction relates to the sound of wet rattle noise. Sounding rattle sounds suggest an origin near the ear, ie in the upper part of the respiratory tract, while non-sounding rattles are more likely to be generated near the bronchi. There is a metallic sound in the so-called pneumothorax.

Dry breathing sounds: stridor, wheezing, whistling, hum

They are caused by viscous secretions in the airways. Mostly there is a swelling of the mucous membrane.

  • Stridor : If it arises in the nose, it sounds like a whistling or hissing, it arises in the trachea or the bronchi, it sounds like a humming.

Possible causes include: foreign bodies in the respiratory tract, asthma (see gallery) , respiratory tract infections, tumors in the respiratory tract

  • Giemen : dry, whistling sound that occurs especially during exhalation.

One-sided girth indicates a foreign body in the airways, bilateral gill is typical of chronic obstructive pulmonary disease (COPD) or bronchial asthma.

  • Whistling : a secondary breath that only audibly sounds when listening to the lungs. It typically occurs in asthma, but also in COPD or a foreign body in the airways.
  • Hum : Hum is a deep flow noise that occurs especially on exhalation.

It is typically caused by the accumulation of mucus in the airways in asthma.

Breathing noise of the pleura (pleural breath sounds)

  • Pleural discs : formed when the pleura and the pleura rub against one another while breathing because they are stuck together as a result of inflammation, for example after pleurisy or pleural empyema (accumulation of pus in the pleural space due to bacterial infection).

Diagnose breathing problems correctly

The doctor can already draw important conclusions about the causes from the type of symptoms described in the medical report (anamnesis) and the subsequent physical examination. He asks, for example, since when the secondary breath sounds, in which situations they occur, if they are associated with other complaints such as shortness of breath and if allergies are known.

He also inquires about family diseases such as asthma or COPD. Among other things, during the physical examination he listens to the lungs and pays attention to the sound and the type of secondary breathing sounds.

As a rule, a lung function test (breath tests, spirometry) follows. Thereafter, depending on the cause further investigations are carried out, for example, blood tests, an allergy test and a reflection of the bronchial tube (bronchoscopy).

This is how breathing disorders are treated

Which therapy must be initiated for existing breathing sounds and respiratory problems depends essentially on the cause of the disease and the severity of the symptoms.

For example, in asthma and COPD, drug therapies that address the severity of the condition are combined with non-medical measures such as respiratory physiotherapy, exercise, patient education, and the administration of oxygen. Inflammations of the bronchi (bronchitis) or the lungs (pneumonia, typical or atypical) are treated with drugs against the causative pathogen.

If the breath sounds are caused by a foreign body, it must be removed by means of bronchoscopy.

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