Simulated Bronchospasm

Lung tumors, cystic fibrosis, a ring of blood vessels around the trachea (tracheal ring), softening of the voice box and windpipe (laryngotracheal malacia), and birth defects (congenital deformities) of heart and lungs can simulate bronchospasm by causing wheezing. An uncommon condition in which digestive juices from the stomach back up into the esophagus may cause wheezing in infants and children. Called "gastro esophageal reflux," this is another sympathetic nervous system reflex that can sometimes cause asthma.

A word here about croup, a viral disease that occurs for the most part in infants and children under 4 years of age. Croup is usually associated with a viral infection of the respiratory tract that can cause swelling of the vocal cords. Swelling diminishes the space through which air passes between the cords, sometimes to the point where no air can pass into and out of the lungs. Accordingly, croup is one of the few true medical emergencies in childhood. It begins quite suddenly, sometimes with a repetitive, harsh, brassy, "tickle" cough and goes on rapidly to wheezing and severe difficulty in breathing.