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Description of the Symptom

This chapter describes pathology that may lead to a persistent cough. A persistent cough is described as one that the person is unable to stop despite basic therapeutic intervention, as in a common cold remedy. A cough is considered persistent, or chronic, after 3 weeks in duration.1

Special Concerns

The physical therapist should consider referral to an appropriate health care provider or be prepared to administer basic life support measures should an individual present with any of the following:

  • Tussive syncope, which is an episode of persistent coughing that becomes so severe in intensity that the person has a syncopal event

  • Productive cough that is:

    • Pink, frothy (suggestive of pulmonary embolism or pulmonary edema)

    • Bright red (suggestive of an active bleed)

    • Dark red (suggestive of an old bleed)

    • Green (suggestive of an active infection)

CHAPTER PREVIEW: Conditions That May Lead to Persistent Cough

Overview of Persistent Cough

A cough is the body's defense mechanism for removing irritating substances from the bronchial airways, thus providing airway hygiene. A persistent cough can disrupt the individual's lifestyle by causing sleep disturbances and throat and voice soreness and diminish the ability to clear secretions in the future.

Two mechanisms can trigger a cough: the expiratory reflex, which serves as a defensive mechanism caused by mechanical stimulation of the larynx and causes expiratory effects, and the enhancement of mucociliary stimulation for airway clearance.2,...

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