[82F] Experiencing cough with phlegm and breathing difficulty

Patient Description

An 82-year-old female is experiencing a cough productive of green phlegm and nasal congestion. The cough, described as occasionally severe, is exacerbated when lying down and has been constant today. The patient also reports difficulty breathing and wheezing, with no associated chest pain. She has felt chills but denies any fever. Her medical history does not include known chronic illnesses. Currently, she is taking Robitussin, Emergen-C Immune, and Zicam, and reports a severe adverse reaction to codeine. No other medications are being taken.

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Arora's Assessment

What might be happening

Based on your symptoms, 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. Symptoms of bronchitis include coughing up thickened mucus, which can be discolored. It's often caused by a viral infection, so antibiotics may not be effective.

    • Treatment typically involves rest, fluids, and over-the-counter cough remedies. However, if your symptoms persist or worsen, your doctor may prescribe other medications.
  • Pneumonia: This is an infection that inflames the air sacs in one or both lungs, which may fill with fluid. Given your age and the presence of green phlegm, this is a possibility. It's important to seek medical attention promptly as pneumonia can be serious, particularly for people in your age group.

    • Treatment typically involves antibiotics, fever reducers, and cough medicine. Hospitalization may be necessary in severe cases.
  • Congestive Heart Failure: This is a chronic condition in which the heart doesn't pump blood as well as it should. While this might seem less likely, given that you don't have a known history of heart disease, it's worth considering because coughing, particularly when lying down, and shortness of breath can be symptoms of this condition.

    • Treatment typically involves medications, lifestyle changes, and sometimes surgery.

What you can do

Given your age and symptoms, it's important to seek medical attention promptly. In the meantime:

  1. Continue to rest and stay hydrated.
  2. Monitor your symptoms closely. If they worsen, seek immediate medical attention.
  3. Avoid exposure to irritants such as smoke and dust, which can make your cough worse.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms worsen or do not improve after a few days.
  • You experience severe difficulty breathing or chest pain.
  • You cough up blood.

Please remember, I'm an AI and this advice is based on the symptoms you've told me. It's important to consult with a healthcare professional who can evaluate your condition and provide appropriate treatment.

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11 mo ago

People Also Ask


What are the common symptoms of bronchitis and how is it treated?

Common symptoms of bronchitis include a persistent cough that produces mucus, fatigue, shortness of breath, slight fever and chills, and chest discomfort. Treatment usually involves rest, fluids, and over-the-counter cough remedies. If symptoms persist, a doctor may prescribe other medications.


How can pneumonia be distinguished from a common cold or bronchitis?

Pneumonia can be distinguished from a common cold or bronchitis by more severe symptoms such as high fever, chills, difficulty breathing, chest pain, and coughing up green or bloody phlegm. A medical evaluation, including a chest X-ray, is often needed to confirm pneumonia.


What are the signs of congestive heart failure that I should be aware of?

Signs of congestive heart failure include shortness of breath, especially when lying down, persistent coughing or wheezing, swelling in the legs, ankles, or feet, fatigue, and rapid or irregular heartbeat. If you experience these symptoms, it's important to seek medical evaluation.


What should I do if my cough and breathing difficulties worsen?

If your cough and breathing difficulties worsen, you should seek immediate medical attention. This could indicate a more serious condition like pneumonia or heart failure, which requires prompt treatment.


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