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Another question - silent chest

Silent chest, what is it exactly? Though I certainly had heard of it even before I ever knew of this forum, I had understood it to be that stage in an attack between SOB, wheezing etc and actually going blue, but am I right? As I was diagnosed with a lobe/part lobe not having air going through last Saturday, I wonder whether that is what I think Lysistrata, especially, refers to from time to time.......and I wonder whether the first out of hours GP I saw actually missed it. I was clearly unwell, but as I neither crackled nor wheezed she decided that extra ammunition, like antibiotics, was not needed, just basically carry on with increased inhaler dose. I will never know - it might not have been there then - but it would have been so nice if it had all been nipped in the bud sooner. Though it is all getting better now. Just wishing for more energy before I go completely stir crazy.

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Hi. As far as i know a silent chest is when your airway is so blocked or you don't have enough airflow into the lungs to make a wheeze sound. It can also happen during a prelonged exacerbation when you are extremely tired and therefore you are breathing very shallowly and not producing a sound

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Hi, I.saw myself name checked so thought I would jump in! It does seem to be one of my specialities - from nothing to lack of noises without a wheeze on the way in - though I have been known to have a wheeze after treatment when things are relaxing. On one occasion the comment was 'oh good a wheeze, it's better than no noise'- and that was not a fun attack.

I'm not entirely sure of all the niceties but you can have shades of it eg decreased breath sounds, reduced air movement, not shifting air, reduced air entry etc - it seems to be described differently by different people. I have also been told I have good air entry but not much noise of anything going out! The more clueless dr seems to see it as a binary thing which it is not, and regard it as impossible unless you are about to expire or be intubated - clearly not the case! It's airways shut too tightly to make the required noises and though I hsve never listened myself, it seems can definitely be along a spectrum- plus as I said I often go quiet and not been in ITU! (Also as I cannot listen to my ,own chest as I have no equipment or skills for it, I can hardly be making it up that I had this sign as one OOH GP.suggested when I mentioned I had it on another occasion- not even the time he was seeing me!)

I wouldn't be surprised if it were.missed as it seems to be quite subtle and need some careful listening to detect. I have had drs listen close in time and one has said normal/clear while another says significantly reduced air movement - I might have got worse in between but it has often been where this seems unlikely. I think some of them are.just better than others at picking it up.

Going to name check Js206 now as she is a medic and should know if I have this wrong!

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Thank you,Lysistrata! I am so glad you jumped in! I can’t listen to my chest either - I have only recently realised the difference between crackles and rattles (I had, and still have, a bit of the latter, but then not the former. I looked it up.) Yes, as there was no sound of air it would be what I had/have, though I hope that has improved now, and a strong, unfortunate suspicion it was missed. Had it with our daughter once, when she was eight, and I remember it well! Then it was referred to as a collapsed lobe in her lung. We managed to get past that one, but, at age 35 she still has asthma.

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It can be quite hard to pick up when listening to chests but only when it’s the whole chest - if it’s part of a lung it’s normally fairly noticeable 😊

I’ve got a stethoscope for placement and so have snuck it out of my bag a couple of times in a&e to listen when I’ve been told I’ve gone quiet (like Lysistrata it’s a specialty of mine!) and it’s a really weird thing to hear (or not hear I guess 😂)

It does tend to depend if people have come across it before though - when I had the paramedics out at the weekend they remarked that I was still getting air in but virtually nothing out and then in the ambulance said “my god I’ve never heard nebulisers result in a wheeze before!” 😂 so often people will not pick it up until they’ve come across it in someone, and then it’s something you don’t forget!

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Sorry brain gone dead and managed to get your name wrong lol! I blame lungs which are in the naughty corner right now.

For some reason I have only ever had the 'air going in but not out' comment from the paramedics - never drs! I did have a lovely junior dr in HDU in Oct who just said 'well if you didn't tell me you didn't wheeze I'd never guess there was anything going on as it sounds normal'(but he then saw me try to move, get very SOB and said 'and you're clearly not even close to being ok right now'). Pretty sure he just couldn't detect it as I was still not making much noise the next day when the outreach nurse came past after I was stepped down.

I also once had a dr who was just disturbingly clueless in every way - I didn't need nebs cos my sats hadn't dropped and various other delightful statements. She told me my chest sounded fine but I noticed that she kept adjusting the stethoscope and tapping it with her finger - with what I know now I strongly suspect I was going quiet and she couldn't pick it up. I don't blame them for not always getting it since it seems like a hard thing to pick up, as long as I don't get 'well you're totally fine' as a result, but she was so clueless generally that I'd have been very surprised if she managed to pick that up!

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I’ve done this to when I’m at home...

It was always fun at uni when we did general medical screening... we always had ‘healthy’ livers to palpate and hearts to auscultated but come respiratory I had the whole class taking their turn to listen to someone ‘abnormal’ (wheeze, wheeze 😅). Now if I know I’m bad I too have a listen if my stethoscopes nearby... silent chest is definitely a weird one esp when you know you *are* breathing! I remember the ‘thank god I can wheeze/cough again’ feeling after nebs too!

Luckily most of my medics have been on the ball about this (case in point my GP last week!)

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Have just remembered I have heard some breath sounds (or BS as I like to call it ;) ) - living with a medic when he was an F1/F2 and he decided to use my speakers to make sure he knew what things sounded like. Don't think they had a silent one but they did have wheeze (sounds IMO like whalesong on a train) and one which sounded like someone walking along a pebbly beach! I think there is also one which sounds like Rice Krispies (wonder if this puts doctors off cereal? ;) )

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I was once told that I had a crackle that sounded like a dove cooing. But I also remember well when our daughter’s lungs sounded like a rusting, clanging old train. At night I put her into bed with me to keep an eye on her, and then we used to listen to her sounds and laugh at them (this would be after advice had been sought), in order to keep panic (mine) under control. Years later she told her then boyfriend about it and he though I was very cruel and uncaring, which frustrated her, as young as she was she had exactly the right idea of what I was doing. She and I had a good laugh about that!

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Thank you for responding! And that is helpful. It was my low right lobe, but don’t know if it was all or just some - or even if that is possible. The same happened to our daughter when she was seven or eight so I have a tad of understanding, just a tad. My main concern right now is getting all the gunk out, as I know it could get infected again, so I am hydrating, huffing and such. My favourite suggestion that I came across for good diagphragmattic breathing, in the long run, is to get a small harmonica and learn to play it! Might just do that as I have a friend who is good at it. Not decided yet.

Oh, goodness, I find all these responses so helpful and reassuring, in part the hindsight hilarity of what is happening! Thank you all!

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I can make noises like a harmonica with my lungs sometimes if I'm bad and I 'cough' (I use the term loosely, it's a very odd sound but not a whistle like an upper airway thing, more like I have in fact swallowed a wind instrument.) The medic I mentioned says 'polyphony!' when I do it. If I practise maybe I can play at concerts? Concerto in E Flat for lung and orchestra :p

I used to play the oboe and do a lot of singing (sadly neither is really feasible currently - the oboe is too hard and the singing I can do a lot of the time, if not how I'd like, but I want to sing in a choir I'm not reliable enough for grrr). It pushed my best peak flow right up and I think did help when I was younger with the asthma - possibly even now! I have had some bad breathing habits which I had to correct, but not as many as I might have done.

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Love it! Yes, let’s start a lung orchestra! Auditions to be had soon!

I had one of those moments with our daughter(now 35, and for many years would not talk Asthma with me - she had had enough of me stuffing a pf, or occasionally an inhaler, into her mouth when younger), but these days she will, and she was back just over Christmas. And she talked rather companionably about making 3 notes when walking (don’t know when) and ‘surely, mum you have that too?’ And talked how that sound could be refined.....

When young I used to sing in choirs and loved it but haven’t for years. Now I feel my time is too taken up anyway, and don’t trust I would have a voice that would work. But today I got caught out: yesterday I down loaded Spotify and some music like and not heard for yonks, kind of sacral jazz. As I know it well I sang along a bit, just to test, but with headphones clearly louder than I realised. I was resting, and did not see my husband come to explore and then ‘conduct’ in the door way, as he told me gleefully later. (He loves music but is a ‘growler with no sense of rhythm, so his conducting would not have been good.)

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Getting your groove back! :D Clearly a musical family using some unusual instruments...

We can get the lung orchestra accompanied by people using spacers badly, with the musical sound. Don't even need asthma for that :p

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Yes! And the soft clicky sound of pfs going as percussion! Not to mention the twist of some inhalers. I think we are onto something!

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Ooh yes my Spiriva and Nexthaler make some good noises! And an air-driven compressor neb makes plenty of noises.

Not entirely related but my boss today complimented me on my colour coordination - my spacer matched my dress! Nice to know I can accessorise stylishly with asthma :p

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Ha, ha, ha! Love that, too! It is all art, isn’t it!

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I am not sure about musical, but I sang in choirs when young, a long time ago, and loved it.

The other night when I was fed up watching yet more drivel on my tablet, but needed a rest, I downloaded Spotify, and found an ancient recording, one I bought back before 1973. I was delighted! So I enjoyed listening (choir, old Swedish hymns and a jazz band, all gentle stuff, but serious music) I decided to try to hum along quietly, just to see if I could. But I wore headphones so was clearly louder than I realised, and unseen by me, my husband decided to explore. He told me later, with glee, that he had stood by the door and conducted me (he has no sense of rhythm) while I lay there singing away like a drunk - his words. At least it gave us a good laugh.

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Haha yes the harmonica chest! 😂 I get that!! Last week I sounded like I had swallowed an orchestra (felt like it too after Christmas to be honest...)

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I make noises like Darth Vader at times even when I think I'm ok lol. I took a short video of my brother's cats playing (crazy cat lady alert! but they're very cute) and I could hear myself breathing throughout.

(We could get them in the orchestra too. They're not asthmatic but they're very loud :p)

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Ooh I wanna join. My seebri make a great rattly sound. AN gave me a mouthpiece for my Ventolin that sounds like a kazoo (yes I'm old enough to remember them) and my spacer for the flutiform has a sound thingy if you breathe to quickly or strongly I can't make it work most of the time as I can't breathe in hard enough but on a good day it plays a tune. Please. This could be the next big viral thingy. Apart from all the chesty infections we seem to get.

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Oh, yes, no discrimination! All similar talent welcomed!

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And our daughter’s dim, but beautiful, Siberian Rupert ( he doesn’t cause her allergy problems, so explicitly sought one and it works for her. She and her partner are also felinly besotted. Even produced a book on Songs to Sing to Yor Cat. Remarkably silly, but it is a good stocking filler for similarly besotted people). He can be good on purry noises, but surprisingly for such a large cat he meeps, rather than miaows. Could be good addition (as long as he doesn’t kill the kittens first. )

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The upside of being weird and not eligible for anti-IgE treatment is that I'm not allergic to any cats!

I know Maine Coons who are surprisingly quiet given their size (they look fairly similar to Siberians it seems)! My brother's two are Burmese which means they are currently relatively small, astonishingly heavy and very loud. At least one of them also would be able to stand up for himself as he's already cleared out the local rodent population (and scattered it in pieces round the house).

Love the idea of songs to sing to your cats! The average Burmese seems to think they're an opera singer and would join in.

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I think Maine Coons are even larger. We had a trio of cats, all mogs. The first one we were very tentative about, not sure how it would pan out with our daughter’s asthma and allergies, but she was an only and I was concerned she had no living creature, human or animal, to rub up against, knock a few corners, and learn how to consider others. She was a very reasonable child, but some of that siblings seem to provide, but not easy to do deliberately as a parent, as we had power and size on our side. Also she was besotted with cats from the toddler age. And it seemed to work so as this cat was almost homeless we adopted him. He became a much loved member of the family for 19 years. He was then followed eventually by two female kittens, serially. The older one was half Persian and half Siamese, so she eventually had Persian features(not expected) but ‘spoke’ a lot like a Siamese. The third one followed inevitably though we did try to resist it. They also led long lives. All through our daughter seemed to cope fine, but once she had left home and came home for visits, she could feel the effect. She then tried to get a course of desensitisation, and somehow wangled a referral to Brompton (from Wales), but after initial disinterest they realised she is atopic, even if not seriously, thus it was unlikely to work well. Thus Rupert entered the scene.

This suddenly seems to have become quite cat oriented...........I could go on for hours, lots of funny memories, but I will restrain myself.

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Two years ago (to the day almost and my breathing has been very bad since) I was admitted with bad double pneumonia. One doctor turned to the other and said very softly “the lungs are very quiet”. I didn’t know whether I should relax or worry more and wasn’t well enough to ask. I have since learned it was not good and indicated very poorly lungs. I now have a chest infection and everything is very loud with crackles and rattles and a rub which a new one for me and I wish I hadn’t looked it up just now.

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Oh, I am so sorry! So this was not what you wanted to hear about. Years and years ago my husband, too, had double pneumonia, not so badly he was admitted, but it was considered very unusual, and he certainly was very poorly. For years after he didn’t tolerate some things well, especially, but not only, cold air. He still always carries an ancient ventolin with him when he travels, but it is a long time since he needed anything like that. I hope your lungs will improve gradually even if it is just very, very slowly.

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When.im.going into a bad attack i initially wheeze more from my throat but then that noise disappears and my chest goes tight and silent with very little air movement. My consultant has now given me a laminated sheet from her that I have to 'produce' to ambulance staff, A&E etc which explains I'm a difficult asthmatic ( is that me being difficult or the asthma? lol) and they are very unlikely to hear my chest wheeze. This was because I had a few scary incidents with inexperienced doctors telling me not asthma attack as no wheeze, to calm down as oxygen was ok............

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Oh, dear, I am sorry to hear you have had such trouble......but not surprised given what I read of people’s (and possibly mine) experiences. Hope the laminated sheet sorts it. Who or whatever is difficult.......;) ....oh, goodness! My semicolon and bracket turned into an emoji! I am an emoji virgin, never craved them, but now I accept I may need change. I am planning an explore.

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I had never heard of silent chest before but often been told chests fine when clearly really bad.

I took friend with Copd to see his GP last Friday and his GP checked him and said "very quiet but that can be common for Copd" first heard a GP say that

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