[36M] With worsening dry cough and chest pressure

Patient Description

A 36-year-old male presents with a dry, hacking cough that has been worsening over the past 4 days. The patient describes increased coughing at night with associated chest pressure. There is no production of phlegm. The patient reports that the sternum hurts when touched and that no interventions have helped to relieve the cough. The symptoms have been progressively getting worse.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Bronchitis: This is an inflammation of the lining of your bronchial tubes, which carry air to and from your lungs. People with bronchitis often cough up thickened mucus, but it can also be a dry cough. It can also cause chest discomfort.

    • Treatment for bronchitis usually involves rest, hydration, and over-the-counter cough suppressants. If it's caused by a bacterial infection, your doctor may prescribe antibiotics.
  • Pneumonia: This is an infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing cough with phlegm or pus, fever, chills, and difficulty breathing. However, it can also present with a dry cough and chest discomfort.

    • Treatment for pneumonia typically involves antibiotics, fever reducers, and cough medicine.
  • Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes chest pain that can be reproduced by pressing on the area of the chest wall.

    • Treatment for costochondritis usually involves rest, heat or cold to the affected area, and over-the-counter pain relievers.
  • Gastroesophageal reflux disease (GERD): This is a chronic disease that occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD. This can result in a dry cough and chest discomfort.

    • Treatment for GERD typically involves lifestyle changes and over-the-counter medications.

What you can do

You should definitely see a doctor for a formal diagnosis and treatment. In the meantime, here are some things you can do:

  1. Rest and hydrate: This can help your body recover from any potential infections.
  2. Over-the-counter cough suppressants: These may help to alleviate your cough.
  3. Avoid irritants: Smoke and other irritants can make your cough worse.
  4. Heat or cold to the affected area: If your chest discomfort is due to costochondritis, this may help.

What you should look out for

Please seek immediate medical attention if you experience:

  • Difficulty breathing or shortness of breath
  • Coughing up blood
  • High fever
  • Chest pain that worsens, especially if it spreads to your arm or jaw or is accompanied by sweating, nausea, or vomiting.

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Please consult with a healthcare provider.

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10 mo ago

People Also Ask


What are the common causes of a dry, hacking cough?

A dry, hacking cough can be caused by several conditions, including viral infections like the common cold, bronchitis, pneumonia, allergies, asthma, or gastroesophageal reflux disease (GERD). It can also be a side effect of certain medications, such as ACE inhibitors.


How can I differentiate between bronchitis and pneumonia?

Bronchitis and pneumonia can both cause coughing and chest discomfort, but bronchitis often involves a dry or productive cough with chest tightness, while pneumonia may present with a cough that produces phlegm, fever, chills, and difficulty breathing. A healthcare provider can perform tests, such as a chest X-ray, to differentiate between the two.


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone (sternum), causing chest pain that can be reproduced by pressing on the area. Treatment typically involves rest, applying heat or cold to the affected area, and taking over-the-counter pain relievers.


Can GERD cause a dry cough and chest discomfort?

Yes, GERD can cause a dry cough and chest discomfort. This occurs when stomach acid or contents flow back into the esophagus, irritating its lining. Managing GERD often involves lifestyle changes, such as diet modifications, and over-the-counter medications to reduce acid production.


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