Crackles (Rales)

Crackles are discontinuous popping sounds that are heard primarily during inspiration. Contrary to popular opinion, they are not from the popping open of alveoli. In the larger airways they are thought to be caused by secretions bubbling in the airways, while in smaller airways they are thought to be caused by the popping open of the airways during inspiration. The sounds are varied, and are said to resemble the sound you hear when rubbing hair close to your ears, the crunching of leaves, or like the tearing of Velcro. Crackles may be differentiated by their quality (fine versus coarse) or by where they fall in inspiration.

Pulmonology Tutorial

Patient 7

This is a middle-aged man with nonischemic cardiomyopathy who underwent left ventricular assist device placement. He has diffuse inspiratory rales thought to be secondary to amiodarone toxicity.

He also has electronic hum of the device.

Crackles

Annotated

Crackles

Annotated