Pulmonary Crackles medically referred to as rales are quite common in the elderly population. It is often considered to be a sign of a cardiac dysfunction. They are defined as respiratory sounds made while breathing in which can heard on the stethoscope. These sounds are not continuous and can be quite loud at times. There are people who tend to have pulmonary crackles without any history of any cardiac impairment; however, these instances are rare and its prevalence is not completely understood in the literature]. This at times may make management of patients difficult especially in people with pulmonary crackles without any evidence of cardiopulmonary diseases.[1]
Despite this, having pulmonary crackles is an important factor in the diagnosis and treatment of various illnesses. Among the various types of pulmonary crackles, bibasilar crackles seem the most common. They emanate from the base of the lungs and point towards an obstructed airflow.[2]
There are primarily two reasons for bibasilar crackles to occur of which one is accumulation of fluid in the lungs and the other is inability of the lungs to completely inflate during the process of inspiration. Bibasilar crackles can be coarse or fine depending on the loudness and duration.[2]
An individual with bibasilar crackles will also have accompanying symptoms based on the cause of the crackles and include problems with breathing, persistent bouts of cough, fever, lower extremity swelling, and fatigue. This article highlights some of the potential causes of Bibasilar Crackles and ways to treat it.[2]
What Causes Bibasilar Crackles and How To Treat It?
Bibasilar Crackles are normally caused due to an issue with either the lung or the heart. Some of the medical conditions that can cause bibasilar crackles are:
Pneumonia: This condition is caused due to an infection in the lungs. As a result of the infection, fluid fills the base of the lungs making breathing difficult for the individual. This is also what causes Bibasilar Crackles. Pneumonia if left untreated can pose a serious threat to the life of the patient. The Center of Disease Control states pneumonia to be the leading cause of loss of life in children under the age of 5 across the globe.[2]
Heart Failure: This is a condition that develops due to the inability of the heart to pump in enough oxygen required by the body to function normally. If the heart is unable to pump in blood, it gets accumulated in the lungs since it has no other exit route.[2]
This pooling of blood is what that causes Bibasilar Crackles. In addition to the crackles, the patient will have difficulty breathing, swelling of the abdominal region, and bouts of coughing. Studies estimate that around 6 million people in the United States are affected by heart failure[2]
Bronchitis: This is yet another medical condition that causes Bibasilar Crackles. Bronchitis occurs when there is inflammation of the bronchial tubes in the lungs. It can be both chronic and acute with acute form of bronchitis being caused by a virus and nicotine abuse being the primary cause behind chronic bronchitis. In addition to Bibasilar Crackles, bronchitis also causes persistent coughing, lethargy, and congestion in the chest[2]
Pulmonary Edema: This medical condition develops when there is accumulation of fluid around the air sacs that are present in the lungs. These air sacs are called as alveoli. Due to the accumulation of fluid, the patient experiences Bibasilar Crackles.[2]
There can be many causes for Pulmonary Edema of which the most common are cardiac dysfunction, injury to the chest, and infections. In some cases, people who are not accustomed to high altitudes or have weak lungs tend to experience this condition when they visit mountains. Apart from Bibasilar Crackles, a patient with pulmonary edema will have problems with breathing, coughing, and bluish discoloration around the mouth.[2]
Pulmonary Fibrosis: This is another common condition that causes Bibasilar Crackles. Pulmonary fibrosis occurs when there is constant scarring of the lungs. There is no known etiology of this condition but studies reflect exposure to radiation and metals like asbestos tend to cause pulmonary fibrosis. A patient with this condition will have Bibasilar Crackles along with cough, difficulty breathing, and unintentional weight loss.[2]
Coming to the treatment of Bibasilar Crackles, it generally depends on the underlying cause. Once the cause is identified and treatment administered in majority of the cases the crackles fade away. However, if the cause is believed to be chronic then the crackles may linger on for a prolonged period of time. Some of the treatment strategies used for treating Bibasilar Crackles includes:
Medications: A patient with Bibasilar Crackles due to heart failure will be given diuretics to clear the fluid accumulation in the lungs. If bronchitis or a bacterial infection is the cause then antibiotics will be prescribed. In some cases, the patient may be given steroids in tapering doses to decrease the inflammation in the lungs.[2]
Oxygen: Difficulty breathing is the most common symptom associated with conditions that cause Bibasilar Crackles. This is the reason why supplemental oxygen may be given to the patient to assist in breathing.[2]
Lifestyle Modifications: In instances where Bibasilar Crackles occur due to a chronic condition then the physician may advise certain lifestyle modifications to decrease the frequency of crackles. The first recommendation made by the physician in terms of lifestyle modifications will be to abstain from smoking as it will make the condition even worse. This will be followed by maintaining a healthy weight, exercising daily, and eating a healthy balanced diet.[2]
In conclusion, bibasilar crackles is normally an indication of something wrong with either the lungs or the heart. Thus it is mandatory for anyone with bibasilar crackles to consult with a physician and get evaluated thoroughly on an urgent basis.[2]
An early diagnosis and management can help a lot in not only getting rid of the crackles but also prevent any complications that may set in. This is especially true for anyone who along with Bibasilar crackles experiences shortness of breath, fatigue, and frequent bouts of cough that is red in color.[2]
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