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Crackles are the clicking, rattling, or crackling noises that may be made by one or both lungs of a human with a respiratory disease during inhalation, and occasionally during exhalation. They are usually heard only with a stethoscope ("on auscultation"). Pulmonary crackles are abnormal breath sounds that were formerly referred to as rales. [2]
Shortness of breath out of proportion to effort being expended. [2] [7] Rapid, heavy or uneven breathing, or uncontrollable coughing. [10] Crackles, rattling or ‘junky’ feelings deep in the chest associated with breathing effort – usually progressively worsening with increasing shortness of breath and may be cause for a panic attack [2] [7]
Causes may include heart failure, kidney failure, narcotic poisoning, intracranial pressure, and hypoperfusion of the brain (particularly of the respiratory center). The pathophysiology of Cheyne–Stokes breathing can be summarized as apnea leading to increased CO 2 which causes excessive compensatory hyperventilation, in turn causing decreased CO 2 which causes apnea, restarting the cycle.
On physical exam, increased breathing rates, increased heart rates, and a low-grade fever 38.5 o C (101.3 o F) are common. [9] [3] Listening to the lungs may reveal crackles in one or both lungs, often starting in the right middle lobe.
Rapid breathing and a rapid heart rate are other signs. [8] [9] With more severe contusions, breath sounds heard through a stethoscope may be decreased, or rales (an abnormal crackling sound in the chest accompanying breathing) may be present. [6] [10] People with severe contusions may have bronchorrhea (the production of watery sputum). [11]
The classic symptoms are shortness of breath, wheezing, and chest tightness. [20] The wheezing is most often when breathing out. [109] While these are the primary symptoms of asthma, [110] some people present primarily with coughing, and in severe cases, air motion may be significantly impaired such that no wheezing is heard. [108]
Subcutaneous emphysema has a characteristic crackling-feel to the touch, a sensation that has been described as similar to touching warm Rice Krispies. [2] This sensation of air under the skin is known as subcutaneous crepitation, a form of crepitus. Numerous etiologies of subcutaneous emphysema have been described.
A death rattle is noisy breathing that often occurs in someone near death. [1] Accumulation of fluids such as saliva and bronchial secretions in the throat and upper airways is the cause. [ 2 ] Those who are dying may lose their ability to swallow and may have increased production of bronchial secretions, resulting in such an accumulation. [ 3 ]