10-Minute Consultation

Stridor in children

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c2193 (Published 4 May 2010)
Cite this as: BMJ 2010;340:c2193

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  1. Laura J L Halpin, paediatric ST21,
  2. Claire L Anderson, paediatric ST32,
  3. Nicole Corriette, general practitioner3
  1. 1Medway Maritime Hospital, Gillingham ME7 5NY
  2. 2Royal Brompton Hospital, London SW3 6NP
  3. 358 Kirby Road, Dunstable LU6 3JH
  1. Correspondence to: L J L Halpin laurajhalpin{at}doctors.org.uk
  • Accepted 7 April 2010

A 6 month old presents to the general practitioner’s surgery with his mother. She is concerned because he has a runny nose and makes a “funny” loud noise when breathing in, which you diagnose as stridor.

What issues you should cover

Stridor is caused by partial upper airway obstruction and is typically heard in inspiration, although it can also be heard on expiration if the obstruction is below the larynx. It sounds different from wheeze, which is a high-pitched whistling expiratory sound, and from stertor, a snoring sound.

How long has the stridor been present?

  • Acute onset stridor is typically associated with infection or an inhaled foreign body.

  • Chronic stridor (weeks to months) is most commonly due to laryngomalacia, “floppy larynx.” It may also be secondary to congenital anomalies (such as haemangioma), birth trauma (such as vocal cord paralysis), or gastro-oesophageal reflux.

Associated features

  • Cough—a “barking” cough, often worse at night, in young children (infants and …

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