Is Your Asthma Causing Lung Sounds?
Medical professionals often use words that the general public doesn’t understand. Words that have become second nature to us sound like complete gibberish to others.
You have more than likely heard some of the words below when either your doctor, respiratory therapist, or nurse is describing what your lungs sound like. I wanted to take some time to explore some of the most common abnormal breath and lung sounds in asthma that we can hear with a stethoscope, and even oftentimes without.
Types of lung sounds linked to asthma
There are several types of lung sounds often heard in people with asthma.
Wheezing
This is the most commonly heard breath sound linked to asthma. While not all people with asthma wheeze, most do.1
Wheezing is generally a higher-pitched whistling sound that occurs most commonly when you breathe out. This happens when the airways are narrowed due to bronchospasms or inflammation. When the airways are severely narrowed, wheezing can be heard when you breathe in as well. It can be heard in all lung fields or just part of the lung, such as the bases.2
Stridor
Stridor is a harsh, high-pitched sound that comes from the upper airways. It has a distinct sound and can almost always be heard without using a stethoscope. Stridor happens when there is disrupted airflow or obstruction.2
In kids, croup, pertussis (whopping cough), epiglottitis, and choking or having something stuck in the upper airway can cause significant stridor. In adults, stridor most commonly occurs due to issues with the vocal cords, such as vocal cord dysfunction (VCD).3
There are 3 different types of stridor:4
- Inspiratory (when you breathe in) – A sign of a blockage above the vocal cords
- Expiratory (when you breathe out) – A sign of a blockage in the windpipe (trachea)
- Biphasic (when you breathe in and out) – A sign of narrowing cartilage just below the vocal cords
In most cases, stridor can be treated and rather quickly reversed with medicines that relax and reduce swelling.4
Rhonchi
If you have ever had a lower respiratory infection, chances are you’ve experienced rhonchi. It’s that rattling, snoring sound that you can often feel inside your lungs. Rhonchi happens when there are secretions in the larger airways that literally rattle around when you breathe. These secretions can often be cleared with a strong cough.2
Things that cause rhonchi include:2
- COPD
- Pneumonia
- Cystic fibrosis
- Bronchiectasis
- Chronic bronchitis
Crackles/rales
These terms are used interchangeably and mean the same thing. Crackles are heard in the smallest airways when there is fluid in them. This is a very distinct sound – it's just like you’re ripping apart 2 pieces of Velcro. Crackles can be caused by several things, including pneumonia, pulmonary fibrosis, acute bronchitis, and bronchiectasis.5
There are 2 types of crackles:5
- Coarse – Coarse crackles are brief and discontinuous popping/bubbling lung sounds. They are loud.
- Fine – Fine crackles are a brief, discontinuous sound that is higher pitched than coarse crackles. They sound like cellophane being crinkled or wood crackling on a fire.
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View all responsesDiminished lung sounds
This means your breath sounds can’t be heard in the bases through a stethoscope. They are tight and difficult to hear. Reduced airflow can cause diminished breath sounds, which can be due to a flare-up of asthma.2
Silent chest
Nothing makes a respiratory therapist more nervous than a silent chest. This is what makes our adrenaline start running on overdrive. A silent chest is just that – silent. It means your chest is so tight that no breath sounds can be heard with a stethoscope. While you are still breathing, it is a hurry to get medicines and treatment to open those airways back up as quickly as we can.2
The next time you hear your healthcare provider use any of these terms to describe your breath sounds, you will have a better understanding of what exactly they mean. Your doctor will be impressed!
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