Understanding Lung Sounds in COPD

What They Mean and How to Communicate Them

When living with chronic obstructive pulmonary disease (COPD) or other respiratory conditions, the noises of your lungs can provide essential clues about your health. Identifying and understanding these sounds can help you and your healthcare team assess the effectiveness of your treatment and make necessary adjustments. 

Lesley Williams, a Registered Respiratory Therapist at Apria with 35 years of experience, states, “Identifying and understanding the unique lung sounds associated with COPD empowers patients to communicate effectively with their healthcare team, leading to more precise treatment adjustments and improved health outcomes.”

Here’s a comprehensive guide to the various lung sounds associated with COPD and how they can aid your care.

Healthy Breathing Noises

In individuals with healthy lungs, breathing is typically silent through the mouth. Any deviations from this norm can signal underlying issues that may need attention.

How Lung Sounds Occur in COPD Patients

A combination of normal breathing and specific pathological processes produces lung sounds. In COPD, the structural changes within the lungs alter these sounds, producing abnormal, adventitious sounds such as wheezing, crackles, and rhonchi.

Common Lung Noises in COPD

Wheezing

Wheezing is a high-pitched whistling sound that can be heard when you breathe.

• Cause: In COPD, wheezing is often due to inflammation, which causes the large and small airways to narrow. This narrowing leads to air vibrating through these constricted pathways.
• Identification: Wheezing is typically louder when you breathe out but can sometimes be heard when you breathe in. While wheezing in one area might indicate a blockage, in COPD, it is usually heard throughout both the lungs and the chest.

Crackling

Crackles, also known as rales, sound like crackling, popping, or clicking.

• Cause: Crackling occurs when small air bubbles pass through fluid, common in COPD, and can indicate a buildup of mucus or pus in the airways.
• Identification: A healthcare professional can hear crackles using a stethoscope, most likely when you breathe in. Coughing can temporarily clear the fluid, making the crackles disappear.

Types of Crackles

• Fine Crackles: These are high-pitched, quick sounds indicating fluid in small airways, often associated with pneumonia and congestive heart failure.
• Coarse Crackles: These deeper, longer sounds occur when air bubbles pass through fluid in larger airways and are more common in people with COPD.
• Biphasic Crackles: A combination of both fine and coarse crackles.
  

Rhonchi

Rhonchi are continuous, lower-pitched sounds that resemble snoring and can be heard using a stethoscope.

• Cause: Rhonchi indicate a fluid buildup in the larger airways, which can mean increased fluid secretion in COPD patients.
• Identification: These sounds are usually heard throughout the lungs and signify the need for a thorough medical evaluation.

The Importance of Communicating Lung Sounds

It is crucial to be able to identify and communicate changes in lung sounds to your healthcare team. Different sounds can indicate various issues, such as narrowed air passages or fluid buildup, necessitating treatment adjustments.

Diagnostic Tools: Spirometry Test

To investigate lung sounds further, your doctor may use a spirometry test. This involves blowing into a small device that measures the airflow out of your lungs, providing valuable information about your lung function.

Understanding the different lung sounds associated with COPD and effectively communicating these to your healthcare provider can significantly impact your treatment and overall health. By being attentive to the sounds your lungs make and seeking timely medical advice, you can better manage your condition and improve your quality of life.

References
McMillen, Matt. “COPD Lung Sounds: Crackling, Wheezing and Rhonchi.” Edited by Adam Smith. COPD Lung Sounds: Crackling, Wheezing and Rhonchi, April 11, 2023. 
Sarkar, Malay, Rajeev Bhardwaz, Irappa Madabhavi, and Mitul Modi. “Physical Signs in Patients with Chronic Obstructive Pulmonary Disease.” Lung India : official organ of Indian Chest Society, 2019. 
Todd, Lindsey. “COPD Lung Sounds: Types, Descriptions, Treatment, and More.” Edited by Adithya Cattamanchi. Medical News Today, September 13, 2023. 
Werner, Carly. “COPD Lung Sounds: Wheezing, Crackling, and More.” Edited by Nick Villalobos. Healthline, January 11, 2024.

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