Approach to a wheezing child
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Wheezing in children can be caused by narrowed airways from conditions like asthma or tracheomalacia. It is heard more during expiration and can be either a single pitch (monophonic) indicating large airway obstruction, or multiple pitches (polyphonic) indicating different levels of obstruction throughout the airways. Children are more prone to wheezing due to increased airway resistance, less compliant chest walls, and differences in cartilage composition compared to adults. A thorough history, physical exam assessing signs of air trapping, and diagnostic testing can help identify the underlying cause and guide treatment and prevention strategies.
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Approach to a wheezing child
- 1. APPROACH TO A WHEEZING CHILD BY Dr. Jyothi
- 2. INTRODUCTION • WHEEZE: a continuous & musical sound that originates due to oscillations in narrowed airways. • Heard in Expiration more commonly than inspiration depending on severity. • Sign of LRT airway obstruction • MONOPHONIC: single pitch; large airways: distal tracheomalacia, bronchomalacia • POLYPHONIC: various pitches: different levels of airway obstruction: Asthma
- 3. WHY CHILDREN ARE MORE PRONE TO WHEEZE? • Resistance • Compliance of chest wall • Cartilage composition • Immunologic and molecular influences
- 4. DDs of wheezing child
- 5. ETIOLOGY
- 6. CLINICAL MANIFESTATIONS • History and Physical Examination
- 7. Pertinent medical history in wheezing infant
- 9. Air trapping
- 12. Treatment
- 13. Prevention
- 14. Prognosis