Inspiratory wheezing refers to wheezing that happens when you breathe in, and expiratory wheezing happens when you breathe out. Both types indicate an issue with your breathing and can occur with other symptoms.

A wheeze is a high-pitched whistling sound heard during breathing. Though it often happens when you exhale, wheezing can also occur when you inhale (inspiration).

Wheezing is usually a sign of narrowing airways or a blockage in the vocal cords. However, there are other causes of this condition. If you’re wheezing and also find it difficult to breathe, seek immediate medical attention.

There are two types of wheezing — inspiratory (when you inhale, or breathe in) and expiratory (when you exhale, or breathe out). Some wheezing may require a stereoscope to detect. If wheezing is loud enough, you may be able to hear it without using a stethoscope.

Expiratory wheezing often indicates narrowing in the small airways or a mild blockage in all or part of your airway, known as an airway obstruction. It commonly occurs with conditions like asthma but can have other causes.

Expiratory wheezing may indicate that your peak expiratory flow rate is reduced. Your peak expiratory flow rate measures how fast you can exhale. If the airway is very reduced, breathing may be silent and not produce a wheezing sound.

Inspiratory wheezing occurs when you inhale. You can have either expiratory wheezing, inspiratory wheezing, or both.

To diagnose the type of wheezing, a doctor typically uses a stethoscope to hear if it’s loudest over your lungs or neck.

Inspiratory wheezing often accompanies expiratory wheezing when heard over the lungs, specifically in an acute exacerbation of asthma. When inspiratory wheezing is heard over the neck, this indicates a narrowing in the large, upper airways in the neck.

Stridor, a higher-pitched sound, can indicate an obstruction in or below the voice box. Like wheezing, it can occur when you breathe in, out, or both.

You may experience additional symptoms along with wheezing.

You may feel short of breath or winded. You may also feel like you are working harder to breathe.

If you see someone who is wheezing, it may look like they are breathing faster or deeper, or breathing heavily. You might be able to notice flaring of the nostrils or “pulling” of the skin above the collarbone or in between the ribs.

Wheezing is often caused by inflammation in your throat or lungs. The whistling sound occurs when air is pushed through narrowed airways.

Wheezing is most associated with asthma. But many conditions can cause wheezing. Most of these conditions have a spectrum of severity from mild to life threatening.

Milder causes can include:

Causes that can potentially be more severe may include:

A doctor may use a chest X-ray to diagnose what’s causing your wheezing when it occurs for the first time. You may also be asked to perform a breathing test.

When it’s an emergency

If you experience wheezing along with certain other symptoms, it may be a medical emergency. You may need to call 911 or your local emergency services.

These symptoms can include:

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Treatment for wheezing ultimately depends on the underlying cause.

If a doctor suspects your wheezing is due to asthma, they may prescribe bronchodilators to open your airways. If bronchodilators do not relieve your symptoms enough, they may recommend steroids to reduce inflammation, which can contribute to asthma.

They may also recommend visiting an emergency room or a hospital stay for continued treatment and monitoring.

If your wheezing is caused by a bacterial infection, a doctor may prescribe antibiotics to treat the condition and associated symptoms.

Wheezing is a high-pitched whistling sound that can happen while you breathe. It can result from a blockage in your airways or a narrowing of your airways.

Inspiratory wheezing refers to wheezing when you breathe in while expiratory wheezing happens when you breathe out.

Treatment can depend on the cause. But if symptoms are severe and make it difficult to breathe, you may need emergency medical attention.