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{{Infobox_Disease |
__NOTOC__
  Name        = Wheeze |
  ICD10      = {{ICD10|R|06|2|r|00}} |
  ICD9        = {{ICD9|786.07}} |
}}
{{Wheeze}}
{{Wheeze}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{CMG}}; {{JFS}}
{{CMG}}; {{JFS}}


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==[[Wheeze causes|Causes]]==
==[[Wheeze causes|Causes]]==


==[[Wheeze differential diagnosis|Differentiating Wheeze from other Disorders]]==
==[[Wheeze differential diagnosis|Differentiating Wheeze from other Conditions]]==
 
== [[Wheeze epidemiology and demographics|Epidemiology and Demographics]] ==


==Treatment of Wheeze==
== [[Wheeze risk factors|Risk Factors]] ==


=== Management of chronic obstructive pulmonary disease (COPD)===
== [[Wheeze natural history|Natural History, Complications and Prognosis]] ==
All patients with COPD should be on a short-acting bronchodilator to be used on as-needed basis for intermittent increases in dyspnea. The purpose of the short-acting bronchodilator is to reduce symptoms and improve lung function. It is recommended to use a short-acting beta agonist plus a short-acting anticholinergic, rather than either alone, to achieve greater benefit. However, monotherapy with either is acceptable. For patients in whom intermittent short-acting bronchodilators are insufficient to control symptoms, a regularly scheduled long-acting inhaled bronchodilator is recommended. The purpose of the long-acting inhaled bronchodilator is to improve symptoms, improve lung function, and reduce the frequency of exacerbations. The effects of the currently available once daily long acting anticholinergic are superior to the effects of the twice daily long acting beta agonists that are available. Theophylline is the least preferred long-acting bronchodilator option because its effects are modest and toxicity is a concern. For patients who continue to have symptoms or repeated exacerbations despite an optimal long-acting inhaled bronchodilator regimen, adding an inhaled glucocorticoid is recommended.     


All patients with COPD should be advised to quit smoking, educated about COPD, and given a yearly influenza vaccination. In addition, the pneumococcal polysaccharide vaccine should be given to patients who are ≥65 years old, or who are younger than 65 years with a forced expiratory volume in one second (FEV1) less than 40 percent.
== Diagnosis ==


===Management of asthma===
[[Wheeze history and symptoms|History and Symptoms]] | [[Wheeze laboratory findings|Laboratory Findings]] | [[Wheeze chest x ray|Chest X Ray]] | [[Wheeze other imaging findings|Other Imaging Findings]] | [[Wheeze other diagnostic studies|Other Diagnostic Studies]]
The optimal treatment of asthma involves the following steps:
#Monitoring of symptoms and lung function by formal periodic pulmonary function testing
#Patient education
#Controlling environmental and trigger factors and co-morbid conditions that contribute to asthma
#Pharmacologic therapy in a step wise fashion depending on the severity of asthma: intermittent (Step 1), mild persistent (Step 2, moderate persistent (Step 3), and severe persistent (Step 4 or 5).
Asthma severity is based upon current level of symptoms, FEV1 or PEFR values, and the number of exacerbations requiring oral glucocorticoids per year.
Medications include: quick-acting inhaled beta-2-selective adrenergic agonists, long-acting inhaled beta agonists, inhaled glucocorticoids, leukotriene receptor antagonists, theophylline, cromoglycates, anti-IgE therapy (omalizumab), and oral glucocorticoids on a daily or alternate-day basis. 


==Treatment==
[[Wheeze medical therapy|Medical Therapy]] | [[Wheeze secondary prevention|Secondary Prevention]] | [[Wheeze cost-effectiveness of therapy| Cost-Effectiveness of Therapy]] | [[Wheeze future or investigational therapies|Future or Investigational Therapies]]


<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>:
==Case Studies==
[[Wheeze case study one|Case #1]]


==Related chapters==
==Related Chapters==
* [[Rales]]
* [[Rales]]
* [[Rhonchi]]
* [[Rhonchi]]
 
{{WH}}
== References ==
{{WS}}
{{Reflist|2}}
 
{{Symptoms and signs}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}


[[Category:Medical signs]]
[[Category:Medical signs]]

Latest revision as of 00:43, 30 July 2020

Wheeze Microchapters

Home

Patient Information

Overview

Pathophysiology

Causes

Differentiating Wheeze from other Conditions

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Laboratory Findings

Chest X Ray

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Wheeze On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Wheeze

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Wheeze

CDC on Wheeze

Wheeze in the news

Blogs on Wheeze

Directions to Hospitals Treating Wheeze

Risk calculators and risk factors for Wheeze

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: John Fani Srour, M.D.

Overview

Pathophysiology

Causes

Differentiating Wheeze from other Conditions

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Laboratory Findings | Chest X Ray | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

Template:WH Template:WS

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