Shortness of breath and cough
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Prevalence and Causes of Shortness of Breath and Cough
Shortness of breath and cough are very common symptoms, especially in patients with advanced diseases. These symptoms can affect 10% to 70% of people with advanced cancer and up to nearly 100% of those with non-cancerous chronic illnesses, depending on the underlying condition. Infections, immune deficiencies, chronic lung diseases, and even occasional smoking can all contribute to these symptomsElliott2021Mittal2019Kaushik2011+6 MORE.
Common Underlying Conditions and Risk Factors
Chronic Diseases and Immune Deficiency
Patients with chronic lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and rare conditions like Swyer-James-Macleod syndrome, often experience persistent cough and shortness of breathElliott2021Kaushik2011Sarkar2024+2 MORE. Immune deficiencies, such as GATA2 deficiency, can lead to repeated infections and ongoing respiratory symptoms.
Infections and Acute Illnesses
Respiratory infections, including pneumonia and COVID-19, are frequent causes of cough and shortness of breath. COVID-19, in particular, can present with these symptoms and may be complicated by other conditions like pulmonary embolism or lung cancer, especially during the pandemicDoroshenko2021An2009.
Smoking and Environmental Exposure
Even occasional smoking and exposure to secondhand smoke are linked to increased rates of cough and shortness of breath among young adults. The more frequently a person smokes, the more likely they are to experience these symptoms.
Diagnostic Considerations
When patients present with cough and shortness of breath, it is important to consider a wide range of possible causes. Imaging, such as chest CT scans, can help identify infections, tumors, or blood clots in the lungsDoroshenko2021An2009. A thorough medical history, including past infections, immune status, and environmental exposures, is also crucialElliott2021Mittal2019Kaushik2011+6 MORE.
Management and Treatment Strategies
Non-Pharmacological Approaches
General supportive measures include reassurance, creating an emergency plan, encouraging physical activity, and teaching relaxation exercises. Other helpful strategies are using a handheld fan for cool air, physiotherapy, and respiratory therapy.
Medications
Opioids are considered the most effective medications for relieving shortness of breath in palliative care settings. Expectorants can help patients with a productive cough, while antitussants (including opioids like morphine and dextromethorphan) are useful for suppressing the cough reflex. Benzodiazepines are sometimes used, but evidence does not show a significant benefit for breathlessness.
Conclusion
Shortness of breath and cough are common symptoms with many possible causes, including chronic diseases, infections, immune deficiencies, and smoking. A combination of supportive care, targeted medications, and careful diagnostic evaluation can help manage these symptoms effectively in most patientsBausewein2013Elliott2021Mittal2019+7 MORE.
Sources and full results
Most relevant research papers on this topic
Shortness of breath and cough in patients in palliative care.
In most patients, shortness of breath and cough can be relieved by a series of therapeutic measures, including reassurance, emergency plans, physical activity, and relaxation exercises.
A 30-Year-Old Immune Deficient Woman With Persistent Cough and Shortness of Breath.
GATA2 deficiency in a 30-year-old woman led to persistent shortness of breath and cough, and multiple infections, including esophageal candidiasis and human papillomavirus-positive squamous intraepithelial lesion of the cervix
Woman with cough and shortness of breath
A 47-year-old woman with COVID-19 pneumonia and a vascularized tumor in her left main bronchus was diagnosed with a rare case of bronchial cancer.
Diagnostic findings in patients with chest pain, cough, and shortness of breath during the COVID-19 pandemic: what else besides pneumonia?
In pandemic COVID-19 conditions, standard imaging methods should be used to identify common causes of chest pain and sudden shortness of breath, complementing native MSCT with contrasting enhancement in high-risk patients.
DOI
Symptoms of cough and shortness of breath among occasional young adult smokers.
Occasional smoking and environmental tobacco smoke exposure are associated with an increase in respiratory symptoms (cough/sore throat and shortness of breath/fatigue) among young adults.
DOI
Efficacy of acupuncture for a cough-related symptom cluster in patients with lung cancer: A randomized controlled trial.
Acupuncture using LU7, LU9, BL13, and BL20 can relieve cough symptoms in lung cancer patients, but does not significantly affect expectoration and shortness of breath.
DOI