Cough, tight chest and wheezing

Cough, chest tightness and wheezing suggest narrowed or irritated airways and should be assessed if new or severe. Wheezing is a high-pitched sound, often more noticeable when breathing out. It can accompany asthma, acute bronchitis, COPD, bronchiolitis or an allergic reaction; symptoms alone cannot identify the cause.

Asthma commonly presents with variable wheeze, cough and chest tightness, often linked to triggers such as exercise, infection, smoke or allergens. Acute bronchitis can temporarily inflame the airways. COPD may cause persistent breathing symptoms, especially in people with a history of smoking or other lung irritants. Bronchiolitis affects young children and may cause noisy breathing, feeding difficulty and tiredness. Allergic rhinitis can contribute to cough through nasal drainage, while anaphylaxis may cause sudden wheeze with swelling, hives or dizziness.

Sit upright, stay calm and avoid smoke, strong scents and known triggers. If you have a prescribed inhaler, follow your written action plan and check that your technique is correct. Do not borrow inhalers or start antibiotics without medical advice. A clinician may listen to your chest, measure airflow or oxygen levels, and decide whether treatment such as a nebuliser is appropriate for the cause and severity.

Get emergency help if wheezing starts suddenly after food, medicine or an insect sting, or occurs with throat swelling, widespread hives, faintness or severe difficulty breathing. Seek urgent care for blue lips, exhaustion, confusion, inability to speak in full sentences, or wheezing that is rapidly worsening or not improving with your prescribed reliever plan. A child who is struggling to breathe, feeding poorly or becoming unusually sleepy needs prompt assessment.

What could be triggering my wheeze, and do I need an asthma or lung-function assessment? How can I tell whether my inhaler is working? Should I have a written action plan? If symptoms happen at night or during exercise, what should I record before review?