High-Pitched Polyphonic Expiratory Wheezing

MANUAL OF CLINICAL DIAGNOSIS

High-pitched polyphonic expiratory wheezing refers to multiple, sharp, continuous breath sounds heard primarily during expiration. These sounds indicate widespread and variable obstruction in the lower airways, typically caused by bronchial and bronchiolar narrowing due to inflammation, spasm, or secretion buildup. The presence of high-pitched polyphonic wheezing is often associated with conditions that cause diffuse bronchoconstriction and may be a sign of both acute and chronic respiratory diseases.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Acute Asthma Exacerbation	Dyspnoea, polyphonic wheezing, cough, chest tightness, use of accessory muscles	Medical history of asthma, physical examination	Spirometry, arterial blood gas analysis, pulmonary function tests
Asthmatic Bronchitis	Productive cough, dyspnoea, polyphonic wheezing, mild fever, fatigue	History of prior bronchitis, physical examination	Chest X-ray, spirometry
Viral Wheezing	Fever, cough, polyphonic wheezing, nasal congestion, mild dyspnoea	Medical history of viral infection, physical examination	Chest X-ray, viral tests (PCR, serology)
Anaphylaxis	Sudden onset of dyspnoea, wheezing, urticaria, hypotension, facial and airway oedema	History of allergen exposure, physical examination	Allergy tests, blood tryptase levels
Acute Pulmonary Oedema	Sudden dyspnoea, orthopnoea, wheezing, crackles, peripheral oedema, pink frothy sputum	History of heart failure, physical examination	Chest X-ray, echocardiogram, arterial blood gas analysis