Basics
In adults, a cough lasting this long is considered chronic.
What is more than 8 weeks?
This imaging study is often used when a patient has chronic cough but a normal chest X-ray, to look for subtle structural lung disease.
What is high-resolution CT of the chest?
The three most common causes of chronic cough in adults with normal chest imaging and no smoking history.
What are upper airway cough syndrome (postnasal drip), asthma, and GERD?
This common comorbidity in obese patients can contribute to chronic cough, may be screened with a STOP-BANG questionnaire, and sometimes improves with CPAP therapy.
What is obstructive sleep apnea (OSA)?
Chronic cough affects approximately this percentage of the general population
What is 10–12%?
Although often normal, the physical exam should check for these findings
What are postnasal drip, wheezing, crackles, or signs of heart failure?
Stepwise empiric treatment for chronic cough typically involves a trial for each of these three conditions.
What are UACS (4 weeks), GERD (8–12 weeks), and asthma (6 weeks)?
If empiric therapy fails, patients may have this likely diagnosis, considered a neuropathic disorder.
What is cough hypersensitivity syndrome?
In children, chronic cough is defined as lasting longer than this duration.
What is 4 weeks?
Name one initial imaging and one pulmonary test often used in chronic cough evaluation.
What are chest X-ray and spirometry?
Inhaled corticosteroids may be used to treat cough from this etiology.
What is asthma or cough-variant asthma?
Name two specialized evaluations used for refractory chronic cough
What are bronchoscopy, sputum eosinophil count, laryngoscopy, or FeNO/methacholine testing?
Name three risk factors for chronic cough.
What are asthma, GERD, ACE inhibitor use, obesity, bronchiectasis, or occupational exposures?
Important components of cough history include cough timing, triggers, and this type of medication often associated with chronic cough.
What are ACE inhibitors?
GERD-related chronic cough treatment often requires this type of therapy plus lifestyle modifications.
What is proton pump inhibitor (PPI) therapy?
For patients with chronic cough unresponsive to medical therapy, first-line management often uses these techniques to reduce cough frequency and improve voice function.
What is behavioral or speech therapy (cough suppression techniques, vocal hygiene)?
Consequences of chronic cough include impaired quality of life, increased respiratory hospitalizations, and this long-term outcome, particularly in smokers.
What is higher all-cause mortality?
This lung test can detect cough-variant asthma if spirometry is normal.
What is methacholine challenge?
Approximately this percentage of patients respond to a stepwise empiric approach for chronic cough.
What is 74%?
Name one neuromodulator medication used for refractory cough and a common adverse effect.
What is gabapentin (dizziness, fatigue) or amitriptyline (sedation), pregabalin, or low-dose morphine (constipation)?