What should you suspect in a patient with wheezes, severe respiratory difficulty, and sudden onset symptoms?

The symptoms described—wheezes, severe respiratory difficulty, and sudden onset—are indicative of an asthma exacerbation. Asthma is a condition characterized by bronchial hyperreactivity, leading to narrowing of the airways and difficulty in breathing. The sudden onset of wheezing and respiratory distress is typical in an asthma attack, often triggered by allergens, respiratory infections, or irritants.

In asthma, wheezing occurs due to the constriction of bronchial muscles and inflammation, which causes airflow obstruction. The acute nature of the symptoms aligns with how patients experience asthma attacks, where they may go from breathing normally to experiencing significant difficulty in a very short period.

Other conditions mentioned, such as chronic bronchitis and emphysema, are chronic obstructive pulmonary diseases (COPD) that typically present with gradual onset of respiratory symptoms and are characterized by more persistent wheezing or productive cough. Pneumonia, while it can cause respiratory distress, usually presents with additional symptoms, such as fever and productive cough, and does not typically manifest with sudden onset wheezing as a primary symptom. Thus, the combination of sudden onset, wheezing, and severe respiratory difficulty leads to the conclusion that asthma is the most likely cause in this scenario.