Which condition is characterized by wheezing on both inspiration and expiration and bronchospasm?

• A. Asthma.
• B. Anaphylaxis.
• C. Bronchiolitis.
• D. Congestive Heart Failure.

Answer: (A)

Bronchospasm with wheezing in the setting of an obstructive, reactive airway disease is the hallmark of asthma. In asthma, the airway smooth muscle constricts, and there’s mucosal swelling and increased mucus, narrowing the airways. This causes turbulent airflow and audible wheezing. While wheezing is most often heard during expiration because that phase is when air flow is most restricted, extensive or severe bronchospasm can produce wheeze during both inspiration and expiration. That combination—wheezing occurring with both phases of breathing due to reversible bronchoconstriction—fits asthma well, since the underlying problem is bronchospasm that responds to bronchodilators.

Anaphylaxis can involve bronchospasm, but it’s a systemic reaction with other signs like hypotension, rash, or airway edema. Bronchiolitis usually affects infants and presents with viral symptoms and diffuse wheeze/crackles rather than prominent, reversible bronchospasm. Congestive heart failure features fluid overload and crackles from edema, not bronchospastic wheezing.