Differential Diagnosis for Wheezing Upon Exhalation
- Single Most Likely Diagnosis
- Asthma: This is the most common cause of wheezing, especially when it occurs upon exhalation (expiration). Asthma is characterized by inflammation, airway hyperreactivity, and reversible airflow obstruction, which leads to wheezing, cough, shortness of breath, and chest tightness.
- Other Likely Diagnoses
- Chronic Obstructive Pulmonary Disease (COPD): COPD, including chronic bronchitis and emphysema, can cause wheezing, particularly in smokers or those with a history of smoking. The wheezing in COPD is usually more persistent and associated with a chronic cough and sputum production.
- Bronchitis: Acute or chronic bronchitis can cause wheezing due to inflammation of the bronchial tubes. This condition often presents with a cough and may produce sputum.
- Do Not Miss Diagnoses
- Pneumonia: Although less common, pneumonia can cause wheezing, especially if it involves the larger airways. It's crucial to consider pneumonia, especially in the context of fever, cough, and other signs of infection.
- Pulmonary Embolism: A pulmonary embolism can cause sudden onset of wheezing, among other symptoms like chest pain and shortness of breath. This is a life-threatening condition that requires immediate medical attention.
- Foreign Body Aspiration: Especially in children, aspiration of a foreign body can cause sudden onset of wheezing or coughing. This is an emergency that requires prompt intervention.
- Rare Diagnoses
- Cystic Fibrosis: A genetic disorder that leads to the production of thick, sticky mucus, which can cause wheezing, among other respiratory and gastrointestinal symptoms. It's more commonly diagnosed in childhood.
- Bronchiectasis: A condition characterized by damage to the airways, leading to their widening and scarring. It can cause chronic cough, sputum production, and wheezing.
- Vocal Cord Dysfunction: A condition where the vocal cords do not function normally, which can cause symptoms similar to asthma, including wheezing, especially during exercise or stress.