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Tracheal obstruction presenting as new-onset wheezing.

F M Fesmire1, R R Pesce

  • 1Division of Emergency Medicine, University Hospital of Jacksonville/University of Florida College of Medicine.

The American Journal of Emergency Medicine
|March 1, 1989
PubMed
Summary

New-onset adult wheezing may signal serious upper airway obstruction, not just asthma. Prompt diagnosis via imaging and pulmonary function tests is crucial for effective treatment.

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Area of Science:

  • Pulmonology
  • Thoracic Surgery
  • Oncology

Background:

  • Reactive airway disease is often the initial diagnosis for adult-onset wheezing.
  • Bronchodilator therapy is a common first-line treatment for presumed reactive airway disease.

Observation:

  • Two cases of adult-onset wheezing initially treated for reactive airway disease are presented.
  • Chest radiographs revealed mediastinal masses causing extrinsic tracheal compression in both patients.

Findings:

  • One patient had inoperable squamous cell carcinoma, while the other had a substernal goiter successfully resected.
  • Resection of the goiter led to complete symptom resolution.

Implications:

  • Physicians must consider upper airway obstruction in adult patients with new-onset wheezing.

Related Experiment Videos

  • Pulmonary function testing with flow-volume loops is recommended for wheezing of uncertain origin.