Q: 62 years old male is admitted to ICU with respiratory distress. Patient has been diagnosed with asthma in the Emergency department (ED) due to wheezing. Patient has a long history of tobacco smoking and the CT chest showed a bronchial mass. How the wheezing sound of asthma can be differentiated from the wheezing sound of a local bronchial narrowing due to bronchogenic cancer?
Answer: Polyphonic vs. monophonic pitch
The diagnosis of asthma is typically made by the associated history of previous episodes, family history, other clinical signs, and workup. It usually occurs early in the life. Wheezes in asthma are audible most commonly on expiration. They can be heard as sounds of multiple different pitches, called "polyphonic." They start and stop at various points in the respiratory cycle and vary in tone and duration over time. In contrast, the wheezing due to a local bronchial narrowing such as in an aspirated foreign body or bronchogenic tumor, is usually single i.e., monophonic, and begins and ends at the same point in each respiratory cycle.
#pulmonary
#physical exam
References:
1. De La Torre Cruz J, Cañadas Quesada FJ, Ruiz Reyes N, García Galán S, Carabias Orti JJ, Peréz Chica G. Monophonic and Polyphonic Wheezing Classification Based on Constrained Low-Rank Non-Negative Matrix Factorization. Sensors (Basel). 2021 Feb 28;21(5):1661. doi: 10.3390/s21051661. PMID: 33670892; PMCID: PMC7957792.
2. Andrès E, Gass R, Charloux A, Brandt C, Hentzler A. Respiratory sound analysis in the era of evidence-based medicine and the world of medicine 2.0. J Med Life. 2018 Apr-Jun;11(2):89-106. PMID: 30140315; PMCID: PMC6101681.
No comments:
Post a Comment