What Is the Connection Between Coughing and COPD?

The pleural cavity is a closed cavity between the visceral and parietal pleura. Due to the elastic retraction force of the lung, it is a negative pressure cavity [-0.29 to 0.49kPa (-3.5cmH2O)]. When a certain cause causes a sharp rise in the alveolar pressure, the damaged lung-pleura ruptures, the pleural cavity communicates with the atmosphere, and the air flows into the chest cavity to form spontaneous pneumothorax. Spontaneous pneumothorax is mostly secondary. Because the lung tissue of some patients has adhered to the parietal pleura, the lung tissue ruptures the fistula or bronchopleural fistula when the pneumothorax is formed, which cannot be closed as the lung compresses, causing the fistula to continue to open. Thoracic pressure is close to zero and becomes open pneumothorax; some patients form a valve-like valve due to bronchoconstriction and semi-obstruction, so that air enters the chest cavity during inhalation and remains here during exhalation. Thoracic pressure can exceed 1.96kPa (20cmH2O ), Become tension pneumothorax; due to the above reasons, spontaneous pneumothorax is often difficult to heal, re-pneumothorax and localized pneumothorax are more common, while simple closed pneumothorax is less.

Cough with dyspnea

Cough with dyspnea is spontaneous pneumothorax (spontaneous pneumothorax refers to the rupture of lung tissue and visceral pleura due to lung diseases, or the breakdown of fine emphysema bubbles near the lung surface, and the escape of air from the lungs and bronchi into the pleural cavity. More common Young men or young people with chronic branches, emphysema, or tuberculosis. This disease is one of the pulmonary emergency cases, and severe cases can be life-threatening and timely treatment can be cured.) One of the symptoms. The clinical manifestations of spontaneous pneumothorax are often atypical and often obscured by the primary disease. About one quarter of the cases have a slow onset and gradually worsen.

Affected area

chest

Related diseases

Pneumothorax children acute laryngitis open pneumothorax tension pneumothorax spontaneous pneumothorax cold drink cough spleen qi autumn dry heat cough trifocal cough qi deficiency cold cough

Related symptoms

Hypoxemia, cyanosis, irritability, over-inflated, dry cough, dyspnea, cough, sputum, pale pus, sputum, tracheal displacement, shortness of breath, pneumothorax, palpitations, myocardial infarction, chest tightness, pleural adhesion, pleural effusion, chest pain, tension pneumothorax

Affiliated Department

Respiratory Medicine

Related inspections

Cerebrospinal fluid glutamine lung ventilation imaging lung impedance blood flow expiratory flow rate respiratory motion examination

The pleural cavity is a closed cavity between the visceral and parietal pleura. Due to the elastic retraction force of the lung, it is a negative pressure cavity [-0.29 to 0.49kPa (-3.5cmH2O)]. When a certain cause causes a sharp rise in the alveolar pressure, the damaged lung-pleura ruptures, the pleural cavity communicates with the atmosphere, and the air flows into the chest cavity to form spontaneous pneumothorax. Spontaneous pneumothorax is mostly secondary. Because the lung tissue of some patients has adhered to the parietal pleura, the lung tissue ruptures the fistula or bronchopleural fistula when the pneumothorax is formed, which cannot be closed as the lung compresses, causing the fistula to continue to open. Thoracic pressure is close to zero and becomes open pneumothorax; some patients form a valve-like valve due to bronchoconstriction and semi-obstruction, so that air enters the chest cavity during inhalation and remains here during exhalation. Thoracic pressure can exceed 1.96kPa (20cmH2O ), Become tension pneumothorax; due to the above reasons, spontaneous pneumothorax is often difficult to heal, re-pneumothorax and localized pneumothorax are more common, while simple closed pneumothorax is less.

Spontaneous pneumothorax is mainly manifested by exacerbation of dyspnea that is difficult to explain in the primary disease; there is no clear cause for the onset of some cases, and it appears as sudden or rapid exacerbation of chest tightness and shortness of breath; 40% to 60% of the cases are suddenly significant after a severe cough. Shortness of breath, chest tightness, palpitation, and difficulty breathing. A small number of patients can also be induced by physical activities, forced defecation, sneezing, and weight bearing.

Chest pain, especially sudden sharp pain typical of pneumothorax, is rare. Other common symptoms include cough, cyanosis, and inability to lie flat. Cough can be irritating dry cough or sputum due to underlying disease. The clinical manifestations of a large number of pneumothorax or tension pneumothorax sometimes resemble pulmonary infarction or myocardial infarction, and chest tightness, chest pain, dyspnea, palpitation, sweating, paleness, and irritability can occur early.

The physical signs are not obvious when there is a small amount of pneumothorax; when the lungs are compressed by more than 30%, the trachea is shifted to the healthy side, the thoracic bulge on the affected side is weakened, the respiratory movement is weakened, the percussion is a drum sound, the heart dullness is down, or the liver dullness is down, and the breath and speech The tremor weakens or disappears, which is sometimes easily confused with emphysema. Some elderly patients are similar to asthma-like attacks, and wheezing may be heard in the lungs with severe breathing difficulties. Most of these patients have severe emphysema, pulmonary insufficiency, pleural adhesions, and multiple rooms. In these patients, shortness of breath and wheezing disappear quickly after pneumothorax drainage.

Pulmonary function test: Restrictive ventilation damage (decreased lung capacity and vital capacity) usually occurs when the pneumothorax is compressed by more than 20%. Due to the existence of underlying diseases in the elderly, pneumothorax often has severe pulmonary dysfunction when the lung compression is less than 20%. Pneumothorax patients who are clinically suspected of having pneumothorax should not be tested for pulmonary function items with forced breathing to avoid deterioration of the condition. Arterial blood gas examination: Right-to-left shunts occur due to ineffective perfusion of collapsed lung tissue in patients with pneumothorax in the onset of hypoxemia. Hypoxemia can be relieved because the blood flow of the collapsed lung is reduced in the later stage. Hypoxemia generally occurs in young people with pneumothorax when the lungs are compressed by 20% to 30%. Spontaneous pneumothorax often occurs when mild pulmonary compression occurs.

X-ray examination: The typical X-ray of pneumothorax is a spherical shadow of the lungs toward the hilum. The gas often gathers outside the chest cavity or the apex of the lung. When the pneumothorax extends to the lower part of the lung, the costosacral angle is sharp. When there is a small amount of pneumothorax, the gas accumulation is mostly confined to the apex of the lungs, which is easily obscured by the clavicle shadow. At this time, deep X-ray signs are helpful for diagnosis. Some patients with spontaneous pneumothorax are limited to pneumothorax due to pleural adhesions. Qi accumulation may be obscured by the lungs or mediastinum, and can only be detected by rotating body perspective examination.

Spontaneous pneumothorax is sometimes distinguished from:

1. Spontaneous pneumothorax exacerbation. Closed pneumothorax secondary to COPD, and sometimes even open pneumothorax is often mistaken for COPD exacerbation. Patients with pneumothorax are prone to shortness of breath, and most of them occur suddenly or progressively, while cough and sputum are correspondingly mild; the exacerbation period of COPD is often induced by climate change, and the above sense is used as a guide, and the cough and sputum are exacerbated. Sputum. The accumulation of air signs is limited or unilateral, with bilateral asymmetry, and the signs of hyperinflation of the lungs are mostly diffuse and bilateral; new tracheal displacements are evidence of pneumothorax. X-ray examination and diagnostic pneumothorax puncture and pressure measurement when necessary can help confirm the diagnosis.

2. Pulmonary bullous pneumothorax or localized pneumothorax sometimes needs to be distinguished from bullae. The occurrence and development of bullae are very slow, and the clinical manifestations are generally stable; fine streaks can still be seen in the area of increased transparency on X-ray chest radiographs, and the changes on chest radiographs have not changed much in the past; the size of bullae shadows after diagnostic puncture and exhaust Unchanged and different from pneumothorax.

3. Pleural effusion: Patients with pleural effusion also often show chest pain and shortness of breath, but physical examination and X-ray examination are different from pneumothorax for signs of effusion.

4. The clinical manifestations of myocardial infarction and pulmonary infarction tension pneumothorax sometimes resemble myocardial infarction and pulmonary infarction. They all show sudden severe chest pain, shortness of breath, dyspnea, palpitation, pale or cyanosis, sweating, restlessness, etc., but the tension Obvious pleural effusion on the affected side of the pneumothorax and contralateral displacement of the trachea help to identify, X-ray examination and diagnostic puncture by artificial pneumothorax can confirm the diagnosis.

5. Bronchial asthma attacks Some elderly patients with pneumothorax behave similarly to asthma-like attacks. Severe dyspnea can be heard while wheezing in the lungs. Pleural effusion, ineffective against antispasmodic-corticosteroid-oxygen therapy, dyspnea and wheeze disappeared after aspiration, which is different from asthma.

prevention:

The key to pneumothorax prevention is to actively prevent primary diseases, especially COPD and respiratory infections. For the elderly with bullae, especially those with a history of pneumothorax, keep the stool open, avoid contact with respiratory irritants, and avoid fatigue and weight bearing. Recurrence of pneumothorax is the main method to prevent recurrence.