When your health care provider holds a stethoscope to your chest or back and asks you to take a deep breath, they are listening for clues about what’s happening inside your body. If you are living with pulmonary hypertension (PH), what does it mean when your doctor tells you they hear lung crackles?

Keep reading to learn what lung crackles are and what people with PH should know about them.

What Are Lung Crackles?

​​Lung crackles may indicate fluid in the lungs. Liquid blockages in small airways can make that sound. When you breathe in, those liquid blockages or plugs rupture, creating 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, a condition caused by excess fluid in the lungs. You may feel like you are running out of air, a condition called dyspnea. You may feel shortness of breath or like you are suffocating or drowning, especially when lying down.

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

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

Several diseases and conditions can cause lung crackles, including:

• Heart failure
• Pulmonary fibrosis
• Chronic obstructive pulmonary disease (COPD)
• Bronchiectasis
• Bronchitis
• Pneumonia
• Cystic fibrosis

An experienced doctor can distinguish between wet and dry lung crackles. The location of the sound can help determine whether the source is heart failure, pulmonary fibrosis, pneumonia, or another heart or lung condition.

Lung Crackles and PH

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 that pulmonary artery pressure is measured at 25 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, like heart disease or lung disease, it’s called secondary pulmonary hypertension.

Listening to your lungs can offer information to help your doctor determine a diagnosis. For example, lung crackles are uncommon with pulmonary arterial hypertension.

Lung crackles can only be heard with a stethoscope, and they tell your doctor that there could be too much fluid in your lungs. Since fluid in the lungs is associated with heart failure, your doctor may diagnose you with secondary pulmonary hypertension if you have lung crackles with other signs of left-sided heart failure, like fatigue and swelling in the legs.

Regardless of how your lungs sound, your health care provider should still perform a complete physical examination. They will likely use a combination of an echocardiogram, blood pressure and oximetry (oxygen level) readings, lung function tests, a chest X-ray, and other diagnostic measures to diagnose your PH.

Lung crackles can also be a sign of disease progression. Since PH forces the right side of the heart to work harder than usual, the extra stress can eventually damage the heart and lungs. Lung sounds with heart failure are common, and lung crackles may be a sign of worsening heart failure.

Lung sounds with left-sided heart failure should not be ignored, as left heart failure is the most common cause of right heart failure. With treatment, you may be able to slow disease progression.

How To Treat Lung Crackles

Treatment for lung crackles depends on what’s causing them. Lung crackles caused by heart disease require different interventions than those caused by chronic lung disease or an infection. Your health care provider can offer suggestions based on your diagnosis and treatment goals.

Common treatments for lung crackles include:

• Oxygen therapy if your oxygen levels are low
• 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 health care provider. They can answer your questions, diagnose the underlying cause, and offer treatment suggestions to improve your quality of life. Also, consider connecting with others who have PH and can relate to what you’re going through.

Talk With Others Who Understand

Join myPHteam, the social network for people with pulmonary hypertension and their loved ones. More than 51,000 members come together as a community to ask questions, give advice, and share their experiences with others who understand life with pulmonary hypertension.

Have you experienced lung crackles with PH? Share your story in the comments below or by posting on your Activities page.