[58F] Experiencing dry cough, chest pressure, and swallowing difficulties

Patient Description

A 58-year-old female has been experiencing a constant dry cough for about 4 months, which has gradually worsened. She also reports significant pressure in her chest, described as feeling like something is stuck, and this sensation has been constant for about 6 months. Additionally, she has had difficulty swallowing for the past 6 months, describing it as feeling like swallowing rocks, with even liquids now being difficult to swallow. She also experiences regurgitation and difficulty breathing, feeling unable to get enough air. The patient describes a sensation in her chest as if she had smoked a menthol cigarette, despite never having smoked. Her medical history includes cirrhosis, arthritis, meningioma diagnosed about a year ago, and she is currently on multiple medications including Lantus, Humalog, Metformin, Simvastatin, Xaxifan, Carvedilol, and Pantoprazole.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Gastroesophageal Reflux Disease (GERD): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus and cause symptoms like difficulty swallowing, chest pressure, and regurgitation. The constant dry cough could be a result of this acid irritating your throat and airways.

    • Treatment typically involves lifestyle changes and over-the-counter medications. In severe cases, prescription medications or surgery might be necessary.
  • Chronic Obstructive Pulmonary Disease (COPD): This is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. It's characterized by difficulty breathing, cough, mucus (sputum) production and wheezing. The sensation of not getting enough air and the constant cough could be symptoms of this condition.

    • Treatment involves medications, pulmonary rehabilitation, oxygen therapy, or surgery in severe cases.
  • Heart Failure: This is a condition where your heart can't pump enough blood to meet your body's needs. Symptoms can include shortness of breath, fatigue, swollen legs, and a rapid heartbeat. The chest pressure and difficulty breathing could be symptoms of this condition.

    • Treatment typically involves medications, lifestyle changes, and sometimes devices or surgical procedures.

Please note that these are only possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for a formal diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider as soon as possible. They can perform tests to determine the exact cause of your symptoms and recommend appropriate treatment.
  2. In the meantime, avoid foods and drinks that can trigger heartburn, such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine.
  3. Try to maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.
  4. Don't smoke and avoid secondhand smoke.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or pressure, especially if it radiates to your arm, jaw, or back
  • Severe difficulty breathing
  • Fainting or loss of consciousness
  • Coughing up blood

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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8 mo ago

People Also Ask


What are the common symptoms of Gastroesophageal Reflux Disease (GERD)?

Common symptoms of GERD include heartburn, regurgitation of food or sour liquid, difficulty swallowing, chest pain, and a chronic cough. Some people may also experience a sensation of a lump in their throat.


How is Chronic Obstructive Pulmonary Disease (COPD) diagnosed?

COPD is diagnosed through a combination of medical history, physical examination, and tests such as spirometry, which measures lung function. Imaging tests like chest X-rays or CT scans, and blood tests may also be used to assess the condition.


What lifestyle changes can help manage heart failure symptoms?

Lifestyle changes to manage heart failure include reducing salt intake, maintaining a healthy weight, exercising regularly, avoiding alcohol and smoking, and managing stress. It's also important to follow a heart-healthy diet and take medications as prescribed.


When should someone seek immediate medical attention for chest pressure?

Immediate medical attention should be sought if someone experiences severe chest pain or pressure, especially if it radiates to the arm, jaw, or back, severe difficulty breathing, fainting, or coughing up blood. These could be signs of a serious condition requiring urgent care.


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