What should you know about cardiac wheeze?

When the heart does not move blood forward effectively, pressure can build in the blood vessels of the lungs. Fluid may then move into lung tissue and narrow the small air passages, producing a whistling or rattling sound. Breathlessness may be worse when lying flat or may wake someone at night. Swollen ankles, rapid weight change, tiredness, or a cough can accompany the breathing problem.

A wheeze alone cannot identify the cause. Acute bronchitis, asthma, COPD, bronchiolitis, allergic rhinitis, and anaphylaxis can also produce noisy breathing or breathlessness. A clinician may listen to the chest, check oxygen levels and heart rate, review medicines, and arrange tests based on the pattern and severity.

Sit upright and avoid lying flat if that makes breathing harder. Use prescribed heart or inhaled medicines exactly as directed; do not borrow another person's inhaler. Reduce exertion, keep a list of current medicines available, and arrange prompt assessment for new or worsening breathlessness, especially if symptoms are worse at night or with ordinary activity.

A nebuliser treatment may be used in an urgent setting for selected airway problems, but it does not replace assessment of possible heart-related fluid congestion. Do not delay help while trying home remedies when breathing is rapidly worsening.

Call emergency services for severe or rapidly worsening breathlessness, blue or grey lips, inability to speak in full sentences, fainting, new confusion, crushing chest pain, or coughing pink or frothy fluid. Sudden wheezing with swelling of the lips or tongue, a widespread rash, or throat tightness may indicate anaphylaxis and needs immediate treatment.

Ask whether the sound is more consistent with heart congestion or an airway condition; which symptoms mean you should use prescribed rescue treatment; whether your medicines need review; and whether you need heart, lung, or allergy testing.