Cough is usually considered acute if it lasts less than 3 weeks and is chronic if it worries the patient for more than 3 weeks. However, this division is relatively, For example, cough with exacerbation of chronic bronchitis with adequate treatment can last less than 3 weeks.
Distinguish also dry (without separation of sputum) and moist (with sputum discharge of a different nature).
In accordance with the clinical characteristics of:
- bitonal (in the sound of two tones - low and extra high), is observed as a sign of compression of the trachea and large bronchi:
- barking (loud, jerky, dry), occurs when the larynx or trachea is affected, sometimes combined with hoarseness and aphonia;
- convulsive (paroxysmal, with rapid successive shocks, interrupted by a noisy inspiration), may be with whooping cough;
- spasmodic (persistent dry, with spasm of the larynx), occurs when the lower laryngeal nerve is irritated;
- deafness occurs with severe emphysema;
- soundless is observed with paralysis or destruction of vocal cords, with tracheostomy, lesions of the recurrent laryngeal nerve;
- resonating, is observed in the presence of caverns and other pulmonary cavities in the lungs;
- nasal (persistent, with pain in the throat).
The presence or absence of sputum is an important diagnostic feature. With such diseases as laryngitis, dry pleurisy, compression of the main bronchi with enlarged bifurcation lymph nodes (tuberculosis, lymphogranulomatosis, cancer metastases, etc.), coughing is dry. In some cases, it can be dry only at the onset of the disease (bronchitis, pneumonia, lung abscess, tuberculosis, bronchogenic cancer, etc.).
With bronhozkazah, abscess, cavernous tuberculosis, chronic bronchitis, the morning departure of sputum accumulated overnight in cavities and bronchi is noted. In the case of bronchiectasias, when they are located in the left lung, sputum goes away in position on the right side, and vice versa. If the bronchiectasis is in the anterior parts of the lungs, sputum is better left in the lying position on the back, and in the back - on the stomach.
Night coughing is observed, for example, with an increase in lymph nodes of the mediastinum (lymphogranulomatosis, tuberculosis, malignant neoplasms). In this case, the enlarged lymph nodes irritate the reflexogenic zone of the trachea bifurcation, and the cough reflex is most pronounced at night, during the period of an increase in the tone of the vagus nerve. With an increased tone of the vagus nerve, there are also night attacks of coughing in bronchial asthma.
You can detect blood in the sputum. Blood discharge with sputum, or hemoptysis, is most often observed with pulmonological disease (tumor, tuberculosis, pneumonia, abscess, bronchiectasis, mycoses, including actinomycosis, as well as influenza) and cardiovascular pathologies (heart defects, thrombosis or embolism vessels of the pulmonary artery). In addition, hemoptysis can be with hematological diseases, systemic autoimmune pathology and some other conditions.
There are complications of this sign, the most frequent of which are insomnia, hoarseness, sweating, pain in the muscles, bones, headache, urinary incontinence. When coughing, it is possible to increase inguinal and the development of diaphragmatic hernias. Serious complications are the development of secondary spontaneous pneumothorax and cough-and-fainting syndrome, formerly called betotopepsy syndrome (loss of consciousness, sometimes combined with seizures, at the height of a coughing fit).
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Types of cough
Depending on the above reasons, a non-productive and productive cough is distinguished. The productive is characterized by the separation of sputum. For some diseases, only non-productive cough is typical, for others, especially inflammatory pulmonological diseases, a productive, usually non-productive. In a number of cases (for example, with acute laryngitis) after the productive phase, the phase of an unproductive cough that results from the decrease in the sensitivity threshold of cough receptors is repeatedly noted. In the latter case, the pathogenetically justified the appointment of non-expectorants, and antitussive agents.
Unproductive cough - dry, paroxysmal, debilitating and not bringing relief - is characteristic for the early stages of acute bronchitis, pneumonia (especially viral), lung infarction, the initial period of asthma attack, pleurisy and pulmonary embolism. Dry coughing with acute bronchitis is often preceded by a feeling of tightness in the chest, difficulty breathing. Also, a similar symptom arises in response to the inhalation of substances irritating the mucous membrane or entering the lumen of the dronchus or trachea of the foreign body.
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The productive cough differs with sputum secretion.
Despite a strong cough push, the sputum can not be expectorated. This is usually due to its increased viscosity or arbitrary swallowing. Often, a minor cough and poor sputum is not considered a sign of the disease (for example, the usual morning cough with a smoker's bronchitis), so the doctor should himself focus on the patient's complaint on this complaint.