The one good thing about cough as a symptom is that it can be produced on demand! And not just to get someone’s attention – think about all the invites & events you can conveniently skip by simply saying you have a cold and producing a few coughs while talking on the phone! 🤣 Jokes aside, a cough that lingers & annoys a patient could have many possible culprits. Of the various adjectives that be used to describe a cough such as raspy, barking, deep, etc., the word HACKING makes a good mnemonic to recall some common causes!
H – Heart Failure ( cardiac cough or cardiac asthma, pleural effusions)
A – Airway reactive disease (Asthma, Cold air, Eosinophilic bronchitis, Beta-blockers etc)
A – Autoimmune conditions (Sarcoidosis)
A – Aspiration while eating, foreign body or from silent GERD
C – Cancer, COPD & Cigarette Smoking
K – Kinins ! e.g. Bradykinin cough from ACE inhibitors
I – Infections (Upper and lower including parasites, mycobacterial & fungal )
N – Nasal Drip (ask about stuff nose, early morning cough, laying-down cough
G – GERD (can happen with both laying or sitting, can happen without heartburn)
Thus, cough is not always a bug, it can be a feature & a clue to many possible conditions!
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