Life-Threatening and Non-Life-Threatening Complications Associated With Coughing

Massive Tension Hemothorax After Pacemaker Implantation

“…The most likely source of hemorrhage in our patient was determined to be intercostal vessel rupture, an infrequent etiology. Intercostal hemorrhage is usually traumatic, but spontaneous cases are reported, usually associated with coagulopathy, vascular fragility, neoplasm, or miscellaneous causes, including cough with or without associated rib fractures [ 2 ]. In our case, the patient’s risk was increased due to vascular fragility related to his age and uncontrolled hypertension, iatrogenic coagulopathy due to apixaban and clopidogrel, and forceful coughing.…”

“…More rarely, hemothorax during pacemaker placement can be associated with intercostal vessel rupture with hemorrhage related to forceful cough. Rapid rise in pleural pressure has been proposed as a mechanism for rupture in at-risk patients [ 2 ]. If tension hemothorax develops, initial stabilization involves drainage of accumulated fluid, blood pressure resuscitation, and transfusion of blood products.…”

Potentials of Antitussive Traditional Persian Functional Foods for COVID-19 Therapy†

“…Epidemiologic studies reveal that droplet expulsion during coughing is one of the most common routes of COVID-19 transmission (Wiersinga et al, 2020). In fact, although cough is a defensive reflex of lungs to clear the respiratory system, excessive cough can trigger a wide range of complications including respiratory, cardiovascular, GI, neurologic, constitutional, genitourinary, musculoskeletal, ophthalmologic, dermatological, and psychosocial problems (Nosalova et al, 2006;Irwin et al, 2020). Several adverse events such as headache, laryngeal trauma, pulmonary interstitial emphysema, and brady-or tachyarrhythmias are reported as possible complications induced by excessive cough in COVID-19 patients (Jalali et al, 2020).…”

Complications of Chronic Cough

“…Although pain, dyspnea, and fatigue are common symptoms of cardiopulmonary disease, they do not pose the risk of physiologic harm that cough does. In this issue of CHEST, Irwin et al 4 provide results of their scoping review of physical and psychosocial complications associated with chronic cough, including those ending in death. This update to a previous review 5 is notable for the range of complications and adverse events in adults and children.…”

“…The scoping review method used by Irwin 4 provides an impressively long list of all the referenced coughassociated complications; the online supplement includes all cited case reports, reviews, and studies of varying designs. Their methods acknowledge that, while the review did not include assessment of bias or causality, their aim was to amass the broad range of cough-associated complications.…”