Stridor
Breathing sounds - abnormal; Extrathoracic airway obstruction; Wheezing - stridorStridor is an abnormal, high-pitched, musical breathing sound. It is caused by a blockage in the throat or voice box (larynx). It is most often heard when taking in a breath.
Considerations
Children are at higher risk of airway blockage because they have narrower airways than adults. In young children, stridor is a sign of airway blockage. It must be treated right away to prevent the airway from becoming completely closed.
The airway can be blocked by an object, swollen tissues of the throat or upper airway, or a spasm of the airway muscles or the vocal cords.
Causes
Common causes of stridor include:
- Airway injury
- Allergic reaction
Allergic reaction
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
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Problem breathing and a barking cough (croup)
Croup
Croup is an infection of the upper airways that causes breathing difficulty and a barking cough. Croup is due to swelling around the vocal cords. I...
Read Article Now Book Mark Article - Diagnostic tests such as bronchoscopy or laryngoscopy
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
Read Article Now Book Mark ArticleLaryngoscopy
Laryngoscopy is an exam of the back of your throat, including your voice box (larynx). Your voice box contains your vocal cords and allows you to sp...
Read Article Now Book Mark Article - Epiglottitis, which is inflammation of the movable cartilage that covers the windpipe
Epiglottitis
Epiglottitis is inflammation of the epiglottis. This is the tissue-lined cartilage that covers the trachea (windpipe) while swallowing. Epiglottiti...
Read Article Now Book Mark Article - Inhaling an object such as a peanut or marble (foreign body aspiration)
Foreign body aspiration
If you swallow a foreign object, it can get stuck in the gastrointestinal (GI) tract from the esophagus (swallowing tube) to the colon (large intesti...
Read Article Now Book Mark Article - Swelling and irritation of the voice box (laryngitis)
Laryngitis
Laryngitis is swelling and irritation (inflammation) of the voice box (larynx). The problem is most often associated with hoarseness or loss of voic...
Read Article Now Book Mark Article - Neck surgery
- Use of a breathing tube for a long time
- Secretions such as phlegm (sputum)
- Smoke inhalation or other inhalation injury
- Swelling of the neck or face
- Swollen tonsils or adenoids (such as with tonsillitis)
- Vocal cord cancer
Vocal cord cancer
Throat cancer is cancer of the vocal cords, larynx (voice box), pharynx, or other areas of the throat.
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Home Care
Follow your health care provider's advice to treat the cause of the problem.
When to Contact a Medical Professional
Stridor may be a sign of an emergency. Contact your provider right away if there is unexplained stridor, especially in a child.
What to Expect at Your Office Visit
In an emergency, your provider will check your temperature, pulse, breathing rate, and blood pressure, and may need to do abdominal thrusts to clear the airway.
Abdominal thrusts
Choking is when someone is having a very hard time breathing because food, a toy, or other object is blocking the throat or windpipe (airway). A cho...
Read Article Now Book Mark ArticleA breathing tube may be needed if you can't breathe properly.
After you are stable, your provider may ask about your medical history, and perform a physical exam. This includes listening to your lungs.
Parents or caregivers may be asked the following medical history questions:
- Is the abnormal breathing a high-pitched sound?
- Did the breathing problem start suddenly?
- Could the child have put something in their mouth?
- Has the child been ill recently?
- Is the child's neck or face swollen?
- Has the child been coughing or complaining of a sore throat?
- What other symptoms does the child have? (For example, nasal flaring or a bluish color to the skin, lips, or nails)
Nasal flaring
Nasal flaring occurs when the nostrils widen while breathing. It is often a sign of trouble breathing.
Read Article Now Book Mark Article - Is the child using chest muscles to breathe (intercostal retractions)?
Intercostal retractions
Intercostal retractions occur when the muscles between the ribs pull inward. The movement is most often a sign that the person has a breathing probl...
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Tests that may be done include:
- Arterial blood gas analysis
Arterial blood gas analysis
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
Read Article Now Book Mark Article - Bronchoscopy
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
Read Article Now Book Mark Article - Chest CT scan
Chest CT scan
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
Read Article Now Book Mark Article - Laryngoscopy (examination of the voice box)
- Pulse oximetry to measure blood oxygen level
- X-ray of the chest or neck
X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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References
Griffiths AG. Chronic or recurrent respiratory symptoms. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 401.
Rose E. Pediatric upper airway obstruction and infections. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 162.
Zalzal HG, Zalzal GH. Stridor in the Infant Patient. Pediatr Clin North Am. 2022;69(2):301-317. PMID: 35337541 pubmed.ncbi.nlm.nih.gov/35337541/.
Review Date: 4/1/2024
Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.