Coarse crackles are abnormal lung sounds that present like gurgling or bubbling sounds. They begin around inspiration and can sometimes extend into expiration.
However, before we jump right into identifying coarse crackles, let’s go over the basics in helping you understand how to identify adventitious lung sounds.
What questions should you be asking yourself while auscultating adventitious lung sounds?
When you’re auscultating lungs sounds you want to tune your ears to take notice of the following things that will help you determine what type of abnormal sound you are hearing:
- Timing: are you hearing it mainly on inspiration or expiration or even both?
- Pitch: low or high pitch?
- Discontinuous or continuous? meaning are you able to distinguish the individual sounds that come in a series and are intermittent (discontinuous)? Or are they a continuous sound?
- Location? large airways (upper respiratory, trachea, large bronchi) vs. small airways (lower parts of the respiratory like the bronchioles or alveoli)
- Does it have defining auditory characteristics that are hard to ignore? for example, harsh-grating, squeaky musical whistling, snoring, or squawking etc.
Coarse Crackles Description
Timing: Occurs around the beginning of inspiration and can extend into expiration and are longer than fine crackles
Pitch: Low-pitched and louder than fine crackles
Discontinuous
Location: large airways like the bronchi
Defining characteristics: gurgling or bubbling sounds that does not go away with coughing
Listen to Coarse Crackles
Causes of Coarse Crackles?
This sound tends to occur because air the patient breathes in hits partially blocked airways (like in the large bronchi) that are blocked with fluid or thick mucus.
So, think of lungs conditions that present with fluid and/or mucus:
- heart failure due to pulmonary edema (fluid in the lungs)
- severe cases of pneumonia
- bronchiectasis (a chronic lung condition where the bronchi are enlarged due to chronic lung disease (cystic fibrosis)
- infections that results in moderate to severe mucus secretions
Now test your knowledge with this coarse crackles quiz.
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References:
Zimmerman B, Williams D. Lung Sounds. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537253/