When your healthcare provider holds a stethoscope to your chest or back and asks you to take a deep breath, they listen for clues about what’s happening inside your body. But if you have pulmonary hypertension (PH) and your doctor hears lung crackles, what does that mean?

Keep reading to learn what lung crackles are and whether you should be concerned.

What Are Lung Crackles?

​​Lung crackles can mean you have fluid in the lungs. Liquid blockages in small airways can make crackling sounds. When you breathe in, those blockages or plugs rupture, making a popping or bubbling noise as the air pushes through.

When lung crackles are caused by fluid in the lungs, you may experience symptoms similar to those of pulmonary edema. This is a condition caused by excess fluid in the lungs. You may feel as though you’re running out of air, a condition called dyspnea. You may feel shortness of breath or like you’re suffocating or drowning, especially when lying down.

Crackles may also be produced without fluid in the lungs. In pulmonary fibrosis, scarring and thickening of the lung tissues occurs. Crackles are produced when closed portions suddenly open and allow airflow.

“My lungs snap, crackle, and pop like Rice Krispies,” one myPHteam member said.

“My lungs snap, crackle, and pop like Rice Krispies.”
— A myPHteam member

Several diseases and conditions can cause lung crackles, including:

• Heart failure — Reduced heart function causing fluid buildup in the lungs
• Pulmonary fibrosis — Scarring of lung tissue leading to breathing difficulty
• Chronic obstructive pulmonary disease (COPD) — Blocked air flow from conditions like emphysema or chronic bronchitis
• Bronchiectasis — Widened, damaged airways with persistent mucus and infections
• Bronchitis — Airway inflammation, often caused by infection or smoking
• Pneumonia — A lung infection causing fluid or pus in the air sacs
• Cystic fibrosis — An inherited condition causing thick mucus in the lungs and other organs

An experienced doctor can tell the difference between wet and dry lung crackles. The sound’s location helps determine whether the source is heart failure, pulmonary fibrosis, pneumonia, or another heart or lung condition.

A member of myPHteam with pulmonary fibrosis described seeing their primary care provider (PCP) because of lung crackles: “I saw my PCP yesterday about my edema, and he ordered a bunch of blood tests … and ordered a chest X-ray as he heard crackles in both of my lower lung lobes. (I have mild pulmonary fibrosis and lung scarring from interstitial lung disease.)”

Lung Crackles and Pulmonary Hypertension

Pulmonary hypertension is high blood pressure in the arteries that bring blood from the right side of the heart to the lungs. PH is diagnosed when pulmonary artery pressure is measured at 20 millimeters of mercury (mm Hg) or greater at rest. When the cause is unknown, the condition is called idiopathic or primary pulmonary hypertension. When there is a known risk factor, such as heart disease or lung disease, it’s called secondary pulmonary hypertension.

Listening to your lungs gives your doctor information to make a diagnosis and rule out other conditions. Lung crackles can be heard only with a stethoscope, and they tell your doctor that there could be too much fluid in your lungs. Since fluid in the lungs is linked to heart failure, your doctor may diagnose you with secondary pulmonary hypertension if you have lung crackles with other signs of left-sided heart failure, such as fatigue (persistent exhaustion that doesn’t improve with rest) or shortness of breath. If the condition isn’t properly treated, it may lead to symptoms of right-sided heart failure like swelling in the legs.

Regardless of how your lungs sound, your healthcare provider should perform a complete physical examination and have a variety of tests done. They’ll likely use a combination of an echocardiogram, blood pressure and oximetry (oxygen level) readings, lung function tests, a chest X-ray, and other tests to diagnose your PH.

Lung Crackles May Be a Sign of PH Progression

Lung crackles can also be a sign that your disease is progressing (getting worse). Since PH forces the right side of the heart to work harder than usual, the extra stress can eventually damage the heart and lungs. Abnormal lung sounds are common with heart failure, and lung crackles may be a sign of worsening heart failure.

Abnormal lung sounds are common with heart failure, and lung crackles may be a sign of worsening heart failure.

Lung sounds with left-sided heart failure should not be ignored, as left-sided heart failure is the most common cause of right-sided heart failure and pulmonary hypertension. By treating your PH, you may be able to slow disease progression. Work closely with your PH specialist to find the right treatments for your condition.

Treatment for Lung Crackles

Treatment for lung crackles depends on the underlying cause. Lung crackles related to heart disease may require different interventions than those caused by chronic lung disease or an infection. Your healthcare provider can recommend options based on your diagnosis and treatment goals.

Common treatments for lung crackles include:

• Oxygen therapy to raise low oxygen levels
• Diuretics to reduce fluid in the lungs
• Bronchodilators to relax the muscles and open the airways
• Inhaled corticosteroids to reduce inflammation

In some cases, lung crackles can be a sign of PH disease progression. In others, they may go away with time and treatment, as some myPHteam members have discovered.

“My pulmonologist didn’t hear any crackling or wheezing in my lungs today,” one myPHteam member shared. “It’s the first time that’s happened since 2016!”

Another member said, “My interstitial lung disease is improving, and there is no more crackling in my lungs.”

If you have difficulty breathing or think you may have lung crackles with PH, talk to your healthcare provider. They can answer your questions, diagnose the underlying cause, and offer treatment suggestions to improve your quality of life.

Talk With Others Who Understand

On myPHteam, the social network for people with pulmonary hypertension and their loved ones, more than 56,000 members come together to ask questions, give advice, and share their experiences with others who understand life with PH.

Have you experienced lung crackles with PH? What has helped you manage this symptom? Share your story in the comments below or by posting on your Activities page.