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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for runny nose and cough

Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6675 Questions

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Posted on Tue, 16 Dec 2014 in Ear, Nose and Throat Problems
Question: Hello,
I have been down with a runny nose and cough past few days. Since this morning however I have had a metallic taste in my mouth, back of my throat and in my nose. I also have pain in my lower right calf which upon researching over the internet pointed to a DVT which came as a suprise! I have no inflamation though, but a feeling of occassional numbness and discomfort. Does this warrant a visit to the A&E and getting in touch with my family doctor? I do have a slight pain in my chest, but not all the time. I dismiss this to coughing and the runny nose. Any help here would be much appreciated...thanks!
doctor
Answered by Dr. Vivek Chail 24 minutes later
Brief Answer:
Suspicion of DVT only in presence of risk factors and symptoms.

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
A calf pain is a very important symptom of DVT (deep vein thrombosis). However as described in medical literature, there can be little symptoms in some patients.

Therefore if you have risks for DVT such as -
1. Inherited blood-clotting disorder
2. Prolonged bed rest like hospitalisation
3. Injury to a limb
4. Being overweight or obese
6. Smoking
7. Cancer
8. Heart failure conditions
9. Inflammatory bowel disease
- I will order for doppler study of lower limb to rule out DVT.

A Doppler scan is a ultrasound based test which is used to pick up clots in patients with DVT (deep vein thrombosis). There is another test called D dimer test which is done in some labs to look for small clot particles in the blood indicating DVT.

If you do not have any of the above listed risk factors, then it is less likely that you might have DVT. In that case its most likely a muscle related pain in the calf.

Running nose and cough can be due to a viral flu and that can also cause muscle pain.

Visiting the A and E is recommended only if you have worsening calf pain with shortness of breath and chest pain. You can get in touch with your family doctor for complete clinical examination and risk assessment for DVT.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Vivek Chail 48 hours later
Hi Dr. XXXXXXX

Thanks for your answer. I visited my doctor today and after having a look at my leg ruled out a DVT saying there was no major swelling or tenderness. However he did recommend a D Dimer quantitative. I got the results this evening and it's well within the normal range. I have a value of 85 ng/mL in a reference range of <278. Can I thus safely rule out DVT?

I did go through the risk factors you mentioned and although I'm obese, none of the others seem to hold true for me. I did however have a slight shortness of breath and pain in my chest and my doctor attributed that to the cold and cough I'm down with it. Given the results of the D Dimer being negative, should I still press for the scan of my lungs? Subsequently, could you help me understand what kind of pain in the chest can be atributed to a DVT and are there any symptoms I should look out for?

Thanks!
doctor
Answered by Dr. Vivek Chail 21 minutes later
Brief Answer:
Suggested complete cardiac check up after recovery from cold.

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

The D dimer test measures small molecules which might be circulating in the blood as a result of clot disintegration. If the D dimer test is negative then it is almost 95 to 97 % confirmed that you do no have a DVT. At given values in your report the probability of DVT is not there.

Only if you had positive D dimer I would have suggested further imaging investigations for DVT. Since it is negative please do not worry about further lung scans and Doppler of lower limb veins. Having a DVT does not mean the patient will always have chest pain. The pain in chest starts only when the clot moves from the leg to the heart and blocks blood supply to lungs and this condition is called pulmonary thromboembolism. The chest pain is usually like due to a small clot is sharp pain felt when breathing in. Often you feel like you can't breathe deeply, as this causes you to catch your breath. In a large clot there is severe pain that might be felt in the centre of the chest behind the breastbone.

Other symptoms to be looked for in DVT and pulmonary embolism are
Breathlessness
Chest pain
Coughing up blood (haemoptysis)
Mildly raised temperature (fever)
Fast heart rate (tachycardia) with pulse more than 100 per minute

Since you are obese and complaining of shortness of breath and occasional chest pain, I suggest you have a complete heart check up including ECG, echocardiography, lipid profile and cholesterols, cardiac enzymes and discuss results with your cardiologist.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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