Clinical manifestation Physical examination Increased anteroposterior diameter of the chest over-resonance on percussion, wheezing all over the chest: when severe dyspnea exists, both breathing sounds and wheezing could be reduced or absent. No symptoms and sighns might be present during the interval of attack, in some cases. wheezing could be noted on exersionClinical manifestation Physical examination: Increased anteroposterior diameter of the chest, over-resonance on percussion, wheezing all over the chest; when severe dyspnea exists, both breathing sounds and wheezing could be reduced or absent. No symptoms and sighns might be present during the interval of attack, in some cases, wheezing could be noted on exersion