Wheezing in the elderly. Asthma and other causes.

The evaluation and treatment of patients who complain of wheezing take on special significance in the elderly. Although asthma may begin late in life, it is distinctly uncommon. When it does, it is clinically undistinguishable from asthma present at an earlier age. If severe, the disease may require treatment with corticosteroids as well as bronchodilators. Any side effects are particularly troublesome in the elderly, and careful patient monitoring is essential. Wheezing in the elderly may also signal the onset of other diseases such as chronic obstructive pulmonary disease, congestive heart failure, pulmonary aspiration, pulmonary embolism, and bronchogenic carcinoma. Consideration of these causes of wheezing will lead to appropriate diagnostic studies and specific therapy.