[54F] Persistent cough and chest tightness with history of lymphoma

Patient Description

A 54-year-old female presents with a severe persistent cough and chest tightness lasting for several months. The cough varies between dry and productive sensations, worsening at night, and is associated with occasional shortness of breath and fatigue. The patient rates the chest tightness as moderate (5/10) and reports that it feels like something is stuck in the chest. There is no actual mucus production, leg swelling, weight gain, or wheezing. The patient's medical history includes lymphoma diagnosed 8 years ago and a sinus infection prior to the onset of the cough. The patient is currently on Prozac and has no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Post-Infectious Cough: This is a persistent cough that remains after a common cold or an upper respiratory tract infection. It can last for many weeks and is due to the inflammation and irritation in the airways caused by the infection.

    • Treatment typically involves cough suppressants, inhaled steroids, or sometimes antibiotics if a bacterial infection is suspected.
  • Chronic Bronchitis: This is a type of chronic obstructive pulmonary disease (COPD) characterized by a long-term cough with mucus. It is often caused by smoking or exposure to certain dusts or fumes.

    • Treatment typically involves medications to open the airways, such as bronchodilators, and to reduce inflammation, such as inhaled steroids.
  • Gastroesophageal Reflux Disease (GERD): This is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD is a common cause of unexplained coughing. It is usually felt as heartburn and can worsen at night.

    • Treatment typically involves lifestyle changes, such as avoiding certain foods and drinks, and medications to reduce stomach acid.
  • Postnasal Drip: This is when excess mucus from the nose drips down the back of the throat. This can cause a cough, often worsening at night, and a sensation of something stuck in the chest.

    • Treatment typically involves treating the underlying cause such as allergies or sinusitis.

Given your history of lymphoma, it would also be important to rule out any recurrence or complications related to this condition.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms:

  1. Stay hydrated: Drinking fluids can help to thin out the mucus in postnasal drips and also soothe an irritated throat.
  2. Use a humidifier: This can soothe an irritated throat and loosen up mucus.
  3. Avoid irritants: Smoke, dust, and fumes can worsen a cough.

What you should look out for

Reasons to see a doctor more urgently:

  • If you notice blood in your mucus or phlegm
  • If you develop a fever (temperature over 100.4°F) or chills
  • If you are experiencing unexplained weight loss
  • If your symptoms worsen or do not improve over time

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. You should seek care from a real health professional to receive a formal diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common causes of a persistent cough that worsens at night?

A persistent cough that worsens at night can be caused by conditions such as post-infectious cough, GERD, postnasal drip, or chronic bronchitis. These conditions can irritate the airways or esophagus, leading to increased coughing when lying down.


How can postnasal drip lead to a sensation of something stuck in the chest?

Postnasal drip occurs when excess mucus from the nose drips down the back of the throat, which can irritate the throat and cause a cough. This sensation can feel like something is stuck in the chest, especially if the mucus accumulates.


What lifestyle changes can help manage symptoms of GERD?

To manage GERD symptoms, lifestyle changes such as avoiding spicy and fatty foods, eating smaller meals, not lying down immediately after eating, elevating the head of the bed, and avoiding alcohol and smoking can be helpful.


When should I be concerned about a persistent cough and seek medical attention?

You should seek medical attention for a persistent cough if you notice blood in your mucus, develop a fever or chills, experience unexplained weight loss, or if your symptoms worsen or do not improve over time.


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