Difficulty breathing & breathing noises • What's behind this?

Breathing difficulties can manifest themselves in the form of secondary noises and shortness of breath that occur when breathing in and / or out. Learn more about causes and therapies here.

Difficulty breathing occur in many forms and gradations. They make up for being conspicuous Breathing sounde (referred to by doctors as secondary breathing noises as rattling noises, whistling or wheezing), which, depending on the cause, occur both when inhaling and exhaling and can be associated with the feeling of not getting enough air. This can be up to complete shortness of breath be increased.

Depending on the underlying cause of the breathing difficulties, other symptoms such as cough, hoarseness, sputum and chest pain may occur in connection with breathing difficulties and breathing noises.

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The causes of difficulty breathing

Diseased breathing sounds arise when breathing is obstructed by mucus or fluid in the airways. Since the breathing sounds can originate from the lungs (Latin: pulmo) itself or from the pleura, the so-called pleura, a corresponding distinction is made between pulmonary and pleural side breath sounds:

  • Additional breathing sounds of the lungs (pulmonary breathing sounds) and
  • wet breathing sounds (rattling noises).

They are generated by thin secretions, such as edema fluid in inflammation. According to their character, the following types of wet rattling noises are distinguished, which can be traced back to various causes:

  • Coarse rattling noises: arise in sections of the lungs with a large diameter; Possible causes: pulmonary edema
  • Medium-bubble rattling noises: arise in sections of the lungs with a medium diameter; Possible cause: bronchitis
  • Rattling noises with fine bubbles: arise in sections of the lungs with a small diameter, i.e. near the alveoli; Possible cause: pneumonia

Another distinction concerns the sound of the wet rattling noises. Ringing rattling noises suggest an origin close to the ear, i.e. in the upper section of the airways, while non-ringing rattling noises are more likely to be generated near the bronchi. There is a metallic sound in the so-called pneumothorax.

If you have these symptoms, go to the doctor!

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Dry breathing sounds: stridor, wheezing, whistling, humming

They are caused by thick secretions in the airways. Usually there is swelling of the mucous membrane.

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

Possible causes are: foreign bodies in the respiratory tract, asthma (see gallery), Respiratory tract infection, tumors in the respiratory tract

Asthma: Symptoms and Triggers
  • Wheezing: dry, whistling sound that occurs mainly during exhalation.

Unilateral wheezing indicates a foreign body in the airways, bilateral wheezing is typical for chronic obstructive pulmonary disease () or bronchial asthma.

  • Pipes: a breathing noise that can only be heard when listening to the lungs. It typically occurs in asthma, but also in COPD or a foreign body in the airways.
  • Hum: Humming is a deep flow noise that occurs primarily when you exhale.

It is typically caused by the build-up of mucus in the airways in asthma.

Additional breathing sounds of the pleura (pleural breathing sounds)

  • Pleural rubbing: occurs when the pleura and lung pleura rub against each other while breathing, because they stick together as a result of inflammation, for example after pleurisy or pleural empyema (accumulation of pus in the pleural space due to a bacterial infection).

Correctly diagnose breathing difficulties

The doctor can already draw important conclusions about the causes from the type of complaints described in the medical interview (anamnesis) and the subsequent physical examination. For example, he asks how long the side noises have existed, in which situations they occur, whether they are associated with other complaints such as shortness of breath and whether allergies are known.

He also asks about family diseases such as asthma or COPD. During the physical examination he hears, among other things the lungs and pay attention to the sound and the nature of the breathing noise.

This is usually followed by a lung function test (breath tests, spirometry). Then, depending on the cause, further examinations will be carried out, for example blood tests, an allergy test and a bronchoscopy (bronchoscopy).

This is how breathing difficulties are treated

Which therapy has to be initiated in the case of existing breathing noises and breathing difficulties depends largely on the cause of the disease and the severity of the symptoms.

In asthma and COPD, for example, drug therapies based on the severity of the disease are combined with non-drug measures such as respiratory physiotherapy, physical training, 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 secondary breathing sounds are caused by a foreign body, this must be removed with the help of bronchoscopy.