An Algorithm for the Diagnosis of Wheezing and Stridor Stridor: Louder, constant-pitch sound over central airways Wheezing: Musical sound produced primarily during expiration Inspiratory Stridor (Supraglottic): • Extraluminal Compression: Goiter, Retropharyngeal abscess • Intraluminal Compression: Malignancy, Foreign body • Inflammatory: Anaphylaxis, Angioedema, Epiglottitis Biphasic Stridor (Glottic/Subglottic): • Functional: Vocal fold paralysis, Paradoxical vocal fold motion • Extraluminal Compression: Malignancy, Vascular ring, aneurysm • Intraluminal Compression: Foreign body • Stenosis: Iatrogenic, Endotracheal intubation Expiratory (Tracheal) Stridor: • Extraluminal Compression: Malignancy, Mediastinal mass, Vascular ring, aneurysm • intraluminal Compression: Foreign body • Stenosis - Iatrogenic: Endotracheal intubation, Tracheostomy - Structural weakness: Tracheomalacia, Connective tissue disorder, GERD - Autoimmune: GPA Lower Airway Wheezing (Intrathoracic): • Bronchoconstriction: Asthma, COPD, Anaphylaxis, Carcinoid • Compression: Extraluminal - Peribronchial pulmonary edema • Infectious: Bronchitis, Bronchiolitis, Parasite • Focal: Mass, Foreign body, Consolidation (Infection, Infarction) #Wheezing #Stridor #Noisy #Breathing #differential #diagnosis #algorithm #pulmonary
