What is the meaning of a high-pitched breath sound, also known as stridor?

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Last updated: February 13, 2025 • View editorial policy

From the Guidelines

A high-pitched breath sound, also known as stridor, typically indicates an obstruction of the upper airways.

Causes of Stridor

  • Stridor can be caused by various conditions, including laryngomalacia, laryngoceles, saccular cysts, laryngeal webs, and atresia, as well as congenital hemangiomas 1.
  • It can also be a symptom of airway obstruction, which may involve the upper or lower airway or both 2.

Clinical Presentation

  • Stridor is often accompanied by other symptoms such as a barky cough, hoarseness, or difficulty breathing 1.
  • In infants, stridor can be a sign of a serious underlying condition, such as congenital laryngeal anomalies or airway hemangiomas 1, 2.

Diagnostic Evaluation

  • Flexible bronchoscopy is a useful diagnostic tool for evaluating stridor in children, as it allows for the examination of the upper airways and the assessment of airway dynamics 2.
  • Other diagnostic tests, such as radiographic imaging and tidal flow-volume loop analysis, may also be used to evaluate stridor and airway obstruction 3.

Management

  • The management of stridor depends on the underlying cause and may involve medical or surgical interventions, such as propranolol therapy for airway hemangiomas 1.
  • In cases of airway obstruction, high-flow oxygen and other supportive measures may be necessary to ensure adequate oxygenation and ventilation 4.

From the Research

Definition of Stridor

  • Stridor is a high-pitched breath sound caused by abnormal air passage during breathing 5, 6, 7, 8
  • It is a clinical sign, not a diagnosis, and can be acute or chronic, congenital or acquired 6, 7

Characteristics of Stridor

  • Stridor can be heard on inspiration or expiration, depending on the location of the obstruction 8
  • It is often described as a loud, musical sound of constant pitch 5
  • The pitch of stridor can vary, but it is typically high-pitched, especially in cases of laryngomalacia 9

Causes of Stridor

  • Stridor can be caused by obstruction in the extrathoracic airway (nose, pharynx, larynx, and trachea) or the intrathoracic airway (tracheobronchial tree) 6, 7
  • Common causes of stridor include laryngotracheal inflammation (croup), laryngotracheomalacia, and foreign body inhalation 7, 8
  • Laryngomalacia is a common cause of stridor in neonates and infants, characterized by a weakening of the larynx and collapse of the laryngeal cartilages into the airway 9

Diagnosis and Management of Stridor

  • The diagnosis of stridor is based on history, physical examination, and further investigations such as flexible airway endoscopy 8
  • The management of stridor depends on the underlying cause and severity of the condition, and may include medical or surgical treatment 9

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.