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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of cough syncope due to A-V conduction block of the heart is reported in this paper. A-V conduction block and lightheadedness were induced by coughing but not by an Aschner test, carotid sinus massage, Valsalva maneuver, pharyngeal stimulation, and stimulation of systemic baroreceptors. Permanent right-ventricular pacing completely abolished the patient's symptoms. The results suggest that hypersensitivity of a broncho-pulmonary reflex to coughing was responsible for the A-V conduction block and resulting syncopes.
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PMID:Cough syncope due to atrio-ventricular conduction block. 716 73

The Mayo Clinic experience with superior vena cava obstruction during the last 20 years was reviewed. The diagnosis of superior vena cava obstruction is often made at the bedside. Typical symptoms include suffusion, dyspnea, cough, and, less commonly, pain, syncope, dysphagia, and hemoptysis. The most important physical findings are the increased collateral veins covering the anterior chest wall and the dilated neck veins with edema of the face, arms, and chest. The chest x-ray film usually shows widening of the superior mediastinum. Of our 86 cases of superior vena cava obstruction, 67 (78%) were due to malignancy and 19 (22%) to benign causes. The cause of obstruction is usually established by bronchoscopy, open lung biopsy, or biopsy of the superficial lymph node. Radiotherapy remains the standard approach for the treatment of superior vena cava obstruction due to malignant disease. It is of particular interest to note that of the six benign cases resulting from thrombosis of the superior vena cava, three were due to the use of central venous catheters. Physicians should be aware of this association.
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PMID:Etiologic considerations in superior vena cava syndrome. 725 2

Simultaneous intraventricular and intraspinal pressure recordings in erect patients with obstructive lesions of th CSF pathways reveal differences in pressure which are frequently transitory and produced by pulsation. In non-acute cases without papilloedema but with suspected hindbrain hernia delay in equalization after pressure pulses may be demonstrated, and after Valsalva's manoeuvre differences between the head and the spine may be generated transiently and be responsible for clinical symptomatology. The particular clinical features related to hindbrain hernia are syringomyelia, cough headache, cough syncope, and lower cranial nerve signs with oscillopsia and cerebellar ataxia. Correction of the pressure dissociation is often associated with marked clinical improvement. It is suggested that this form of testing may be of relevance as an indication for operation and also for monitoring the progress of post-operative patients.
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PMID:Simultaneous cerebral and spinal fluid pressure recordings. 2. Cerebrospinal dissociation with lesions at the foramen magnum. 731 57

The history and physical examination were assessed in 215 patients with acute pulmonary embolism uncomplicated by preexisting cardiac or pulmonary disease. The patients had been included in the Urokinase Pulmonary Embolism Trial or the Urokinase-Streptokinase Embolism Trial. Presenting syndromes were (1) circulatory collapse with shock (10 percent) or syncope (9 percent); (2) pulmonary infarction with hemoptysis (25 percent) or pleuritic pain and no hemoptysis (41 percent); (3) uncomplicated embolism characterized by dyspnea (12 percent) or nonpleuritic pain usually with tachypnea (3 percent) or deep venous thrombosis with tachypnea (0.5 percent). The most frequent symptoms were dyspnea (84 percent), pleuritic pain (74 percent), apprehension (63 percent) and cough (50 percent). Hemoptysis occurred in only 28 percent. Dyspnea, hemoptysis or pleuritic pain occurred separately or in combination in 94 percent. All three occurred in only 22 percent. The most frequent signs were tachypnea (respiration ate 20/min or more) (85 percent), tachycardia (heart rate 100 beats/min or more) (58 percent), accentuated pulmonary component of the second heart sound (57 percent) and rales (56 percent). Signs of deep venous thrombosis were present in only 41 percent and a pleural friction rub was present in only 18 percent. Either dyspnea or tachypnea occurred in 96 percent. Dyspnea, tachypnea or deep venous thrombosis occurred in 99 percent. As a group, the identified clinical manifestations, although nonspecific, are strongly suggestive of acute pulmonary embolism. Conversely, acute pulmonary embolism was rarely identified in the absence of dyspnea, tachypnea or deep venous thrombosis.
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PMID:History and physical examination in acute pulmonary embolism in patients without preexisting cardiac or pulmonary disease. 746 69

A 61-year-old previously healthy woman had been suffering from a dry cough for several weeks. On auscultation she had a 3/6 holosystolic murmur. The electrocardiogram (ECG) showed incomplete right bundle branch block (IRBBB) and abnormal repolarisation. Conventional and oesophageal echocardiography revealed a right ventricular tumour and significant coronary heart disease. At operation a tumour, arising from the interventricular septum and histologically consisting of thyroid tissue, was resected. In addition, the left mammary artery was anastomosed to the anterior interventricular branch of the left coronary artery. A 34-year-old woman developed increasing exertion-independent dyspnoea. For years she had had occasional attacks of palpitations and restlessness, once even a syncope. The ECG showed IRBBB, echocardiography demonstrated a tumour attached to the right side of the interventricular septum. The tumour was removed and found histologically to consist of colloid-containing thyroid follicles. Both tumours were benign. 45 and 36 months, respectively, later both patients are free of symptoms.
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PMID:[Ectopic thyroid tissue in the heart--two case reports]. 755 61

To date, pulmonary oedema in breath hold divers has only been reported after dives below 50 meters, hypoxaemic syncope being the most common risk. We recently observed a 35-year-old well-trained breath hold diver who was unable to achieve deep inspiration during a high-level competition. After two hours of repeated dives to a depth of 25 meters for approximately 2-minute periods with intermittent recovery the patient developed cough and haemoptysis. The chest X-ray revealed lung images suggestive of intra-alveolar haemorrhage. The patient had taken 1 g of aspirin per os for three days prior to diving. Symptoms subsided spontaneously in 48 hours and one month later all haematology tests were normal except for minimal alteration of platelet aggregation. Pulmonary oedema in breath hold divers is usually attributed to blood shift to the pulmonary circulation related to the lowered intra-thoracic pressure. In our case, oedema was secondary to intra-alveolar haemorrhage favoured by aspirin which should be avoided before breath hold diving.
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PMID:[Intra-alveolar hemorrhage. An uncommon accident in a breath holding diver]. 756 35

A case of tracheobronchomalacia (TBM) in a 71-year-old woman, who had suffered a cough syncope, is reported. It was a combination of both the crescent type (the posterior membranous portion of trachea or bronchus protrudes into the lumen) and the saber-sheath type (the lateral cartilaginous wall of trachea or bronchus protrudes into the lumen). In this patient, acute bronchitis had developed superimposed upon a chronic bronchitis in addition to age-related regressive changes of the trachea and bronchus. A TBM due to acute inflammation can be reversible, but aggressive airway management as well as medical treatment of the underlying inflammation are critical to a successful outcome.
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PMID:Reversible acquired tracheobronchomalacia of a combined crescent type and saber-sheath type. 778 24

The demographics and natural clinical history of canine congenital subaortic stenosis (SAS) were evaluated by retrospective analysis of 195 confirmed cases (1967 to 1991), 96 of which were untreated and available for follow-up evaluation. Of these, 58 dogs had left ventricular outflow systolic pressure gradients available for assessment of severity. All 195 dogs were used for demographic analysis. Breeds found to be at increased relative risk included the Newfoundland (odds ratio, 88.1; P < .001), Rottweiler (odds ratio, 19.3; P < .001), Boxer (odds ratio, 8.6; P < .001), and Golden Retriever (odds ratio, 5.5; P < .001). Dogs with mild gradients (16 to 35 mm Hg) and those that developed infective endocarditis or left heart failure were diagnosed at older ages than those with moderate (36 to 80 mm Hg) and severe (> 80 mm Hg) gradients. Of 96 untreated dogs, 32 (33.3%) had signs of illness varying from fatigue to syncope; 11 dogs (11.3%) developed infective endocarditis or left heart failure. Exercise intolerance or fatigue was reported in 22 dogs, syncope in 11 dogs, and respiratory signs (cough, dyspnea, tachypnea) in 9 dogs. In addition, 21 dogs (21.9%) died suddenly. Sudden death occurred mainly in the first 3 years of life, primarily but not exclusively, in dogs with severe obstructions (gradient, > 80 mm Hg; odds ratio, 16.0; P < .001). Infective endocarditis (6.3%) and left heart failure (7.3%) tended to occur later in life and in dogs with mild to moderate obstructions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The natural clinical history of canine congenital subaortic stenosis. 788 29

During prolonged coughing, intrathoracic and intra-abdominal pressures are transmitted via the great veins to the intracranial compartment, causing transient elevated intracranial pressure. The resulting reduction of cerebral perfusion pressure may cause a critical impairment of cerebral blood flow (CBF). Obstructive airway disease seems to be a prerequisite to build up the intrathoracic and intracranial pressures to a degree sufficient to compromise CBF and cause cough syncope. Using transcranial Doppler sonography (TCD) monitoring of middle cerebral artery flow velocities, we studied three patients with cough syncope. During coughing, they showed a transient cerebral circulatory arrest, which coincided with loss of consciousness in the two patients who fainted during TCD monitoring. EEG showed slowing, heart rate increased, and systemic arterial BP in one patient was preserved during the syncope. Our findings support the hypothesis that a critical reduction of CBF causes cough syncope.
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PMID:Transient cerebral circulatory arrest coincides with fainting in cough syncope. 789 4

Thirty-five patients (10 men and 25 women) with a preoperative diagnosis of cardiac myxoma have undergone cardiac surgery since 1964 at the University of Louvain. The mean age of the patients was 49 (range 20-75) years. The most commonly encountered symptoms were: dyspnoea 49%; thoracic pain 26%; cough and peripheral embolism 17% each; stroke and preoperative atrial fibrillation 14% each; flutter 11%; expectoration, acute pulmonary oedema, syncope and transient ischaemic attack 6% each; and pulmonary embolism 3%. The different locations were: left atrium 66%; right atrium 26%; both atria 3%; right ventricle 3%: and retrohepatic vena cavae 3%. Septal implantation was found in 66%. Histological examination confirmed 28 myxomas but three 'tumours' were thrombi, two haemangiomas, one rhabdomyosarcoma and one liposarcoma. The follow-up has now reached 2829 months with an average of 81 months per patient (range 0-342 months). Three patients died early (9%) and there were four late deaths (11%). No cases were familial. Surgical resection is the correct treatment for cardiac myxomas and gives good long-term results.
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PMID:Cardiac myxoma. 807 15


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