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Clinical approach to coughing

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Abstract

Coughing is a normal function that serves to expel secretions from the airways, prevent inhalation of material into the airways and delay entry of material deeper into the lungs. It is therefore an extremely important mechanism in the protection of the respiratory system. This raises the issue of control of coughing in disease situations, where the benefits of coughing might outweigh the benefits of supressing the cough. In fact, in some situations, such as chronic bronchitis, stimulating coughing by chest coupage is believed to be therapeutically beneficial. The following are addressed: Mechanism; Causes; Differentiation between cardiac and respiratory origin; and Differential diagnoses for respiratory causes.

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Figures

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2.1 Dynamic collapse of the left mainstem bronchus at end-expiration by an extraluminal mass (primary lung tumour).
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2.2 Lateral thoracic radiograph of a dog with CHF due to myxomatous mitral valve disease. Note the marked cardiomegaly, displacement of the caudal trachea, carina and mainstem bronchi by the enlarged LA, and the partial compression of the left mainstem bronchus. This is a major contributing cause to the dog’s coughing.

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