Monophonic Expiratory Wheezing

MANUAL OF CLINICAL DIAGNOSIS

Monophonic expiratory wheezing refers to high-pitched, continuous breath sounds heard during expiration, typically caused by partial obstruction of the large airways. These sounds indicate a fixed restriction in airflow, usually due to mechanical obstruction or structural alteration in the lower airways. Identifying the underlying cause is crucial, as some of these conditions can be serious and require immediate medical intervention.

Pathology	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Endobronchial Carcinoma	Persistent cough, haemoptysis, dyspnoea, monophonic expiratory wheezing	Medical history, physical examination, smoking history	Chest X-ray, computed tomography (CT), bronchoscopy, biopsy
Acute Bilateral Vocal Cord Paralysis	Dyspnoea, weak or breathy voice, monophonic expiratory wheezing, difficulty speaking	Medical history, physical examination, signs of respiratory obstruction	Laryngoscopy, video laryngoscopy
Inhaled Foreign Body	Sudden onset of coughing, choking, cyanosis, monophonic wheezing, unilateral decreased breath sounds	History of aspiration, physical examination, signs of obstruction	Chest X-ray, bronchoscopy
Tracheal Tumour	Progressive dyspnoea, persistent cough, haemoptysis, monophonic wheezing	Medical history, physical examination, signs of obstruction	Chest CT, bronchoscopy, biopsy
Extrinsic Compression by Mediastinal Mass	Dyspnoea, cough, monophonic wheezing, dysphagia	Medical history, physical examination, signs of obstruction	Chest CT, magnetic resonance imaging (MRI), biopsy
Extrinsic Compression by Oesophageal Tumour	Dysphagia, regurgitation, monophonic wheezing, weight loss	Medical history, physical examination, signs of obstruction	Oesophageal endoscopy, chest and abdominal CT, biopsy
Blunt Tracheal Trauma	Chest pain, dyspnoea, haemoptysis, monophonic wheezing	History of trauma, physical examination, signs of obstruction	Chest CT, bronchoscopy, laryngoscopy