Lung Sounds: Crackles in the Lungs

Lung sounds, crackles, rales or breath sounds are popping sounds coming from the airway. The crackling originates if a choked airway suddenly opens up, resulting in sound vibrations in the airway. Crackles in the lungs are created during inhalation and exhalation of air. These sounds can be heard only through a stethoscope. When these noises arise from both the lungs, situated on both the sides of heart, it's termed as bilateral crackling, whereas, when the crackles in the lungs originate from the base of the lungs, it's called basilar crackling.

Causes of Lung Crackles

The following are the causes of lung sounds, crackles or rales.

• Pulmonary Edema: Pulmonary edema is an excessive fluid accumulation in alveoli, which are air sacs of the lungs. Heart failure can lead to fluid in lungs. Heart fail results in fluid build up and impede flow of oxygen through the lungs. This can be the result of a side effect of a medicine, infection or trauma. Pulmonary edema triggers fine crackles or lung sounds or wheezing during breathing.
• Pneumonia: Infection, leading to an inflammation of the lungs is termed as pneumonia. Bacteria, viruses, fungi or parasites, over a prolonged period can cause chronic pneumonia. Pneumonia also leads to crackles or rales.
• Bronchitis: One more triggering factor for crackles is bronchitis. The lining in the bronchial tube gets inflamed, in bronchitis, which leads to coughing and wheezing during breathing.
• Atelectasis: Atelectasis is one of the most common ailments that cause lung crackling. Lung atelectasis is developed due to collapsing of the lungs, making them airless. It is created due to choked airway or stress on the lungs. In case of obstructive atelectasis, bronchial tubes get congested due to a foreign body, tumor or a mucus plug.
• Pulmonary Fibrosis: Pulmonary fibrosis develops breathing problems and causes lung tissue scarring.

Types of Crackles

4 most commonly observed abnormal crackling sounds are:

• Wheezes: High pitched sounds created due to constricted airways. Wheezes develop during exhaling and sometimes can be heard without a stethoscope.
• Rales: Rattling or bubbling sounds created in the lungs. Rales are dry and fine crackles or lung sounds.
• Stridor: Similar to wheezing, and created during breathing. It causes due to blocked airflow in trachea.
• Rhonchi: These are sounds which appear like snoring and produced due to blockage in the airway (air blockage).

Lung Crackles Treatment

Treatment for lung sounds can be initiated after detecting the cause of the crackles. If the cause is pulmonary edema, the treatment starts with oxygen supply through prongs lodged on the nasal area and a breathing tube lodged into trachea. Need for a ventilator may arise. It is extremely important to detect the cause of edema. For instance, if a heart attack has led to edema, the treatment must be started for steady heart functioning. Medicines which drain excess fluid in the body and enhance the functioning of the heart muscles are administered. If pneumonia is the cause, your physician decides whether you need to be hospitalized. Pneumonia treatment involves antibiotics and fluids administered through veins. If atelectasis is the cause, trachea is suctioned to open the airway and oxygen is administered. Bronchoscopy can also be used for the treatment. If pulmonary fibrosis has triggered lung sounds, pulmonary fibrosis treatment is given to prevent the disease spread and control its symptoms. Pulmonary rehabilitation and lung therapy are recommended. If the patient doesn't respond to these, lung transplant remains to be the last option. Bronchitis treatment includes taking cough suppressants and breathing in moist air.

Addictions like smoking and desk bound activities throughout the day, in urban areas, are observed to lead to lung diseases, resulting in lung sounds, crackles or wheezes. Change in the lifestyle and refraining from addictions like smoking would always help to enhance the lung functioning.