Noisy breathing in children: history and presentation hold many clues to the cause.

Evaluation of noisy breathing in children begins with careful history taking and physical examination focusing on the patient's age and the character of the noisy breathing. Establishing whether stridor, wheezing, rales, or a combination of these is present and whether the problem is acute or chronic can rule out certain disorders and suggest others. From this point, further diagnostic testing can be pursued and appropriate therapy initiated.