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Suggest treatment for difficulty breathing and cough at night

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Posted on Thu, 19 May 2016
Question: my 92 year old dad is really breathing hard at night, lots of coughing.. seems like lungs have fluid. However, in the day seems better. Thoughts?
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Answered by Dr. Ilir Sharka (42 minutes later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello,

Welcome on HCM!

Regarding your concern, I would explain that facing your dad's clinical scenario it is necessary to get through a differential diagnosis.

Difficulty breathing and coughing especially at night may be an expression of:

(1) heart failure; in such case a careful physical exam, a resting ECG (for confirming/excluding a possible arrhythmia or ischemic changes); chest X ray study (for investigating lung overload with fluids), and especially a cardiac ultrasound (for etimating cardiac structure and function) would be the rationale approach in properly addressing the health situation.

Confirming heart failure diagnosis would lead to appropriate therapy with diuretics and vasodilators.

(2) acute respiratory infection/or exacerbation of a chronic broncho-pulmonary disorder. Coming to this point, it is necessary to perform some additional lab tests (complete blood count, PCR, arterial blood gas analysis, liver and renal function tests, blood electrolytes level, chest X ray study, etc).

Antibiotics and bronchial dilators would be of great heal in relieving this situation.

You need to discuss with his attending physician on the above mentioned issues.

Hope you will find my answer helpful.

In case of any further uncertainties, do not hesitate to ask me again.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8371 Questions

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Suggest treatment for difficulty breathing and cough at night

Brief Answer: I would explain as follows: Detailed Answer: Hello, Welcome on HCM! Regarding your concern, I would explain that facing your dad's clinical scenario it is necessary to get through a differential diagnosis. Difficulty breathing and coughing especially at night may be an expression of: (1) heart failure; in such case a careful physical exam, a resting ECG (for confirming/excluding a possible arrhythmia or ischemic changes); chest X ray study (for investigating lung overload with fluids), and especially a cardiac ultrasound (for etimating cardiac structure and function) would be the rationale approach in properly addressing the health situation. Confirming heart failure diagnosis would lead to appropriate therapy with diuretics and vasodilators. (2) acute respiratory infection/or exacerbation of a chronic broncho-pulmonary disorder. Coming to this point, it is necessary to perform some additional lab tests (complete blood count, PCR, arterial blood gas analysis, liver and renal function tests, blood electrolytes level, chest X ray study, etc). Antibiotics and bronchial dilators would be of great heal in relieving this situation. You need to discuss with his attending physician on the above mentioned issues. Hope you will find my answer helpful. In case of any further uncertainties, do not hesitate to ask me again. Kind regards, Dr. Iliri