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Suggest treatment for severe cough and loss of consciousness

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Posted on Wed, 27 May 2015
Question: Good Evening
I am a Male 49 Yrs. I have a History of Respiratory concerns (I am a Smoker) I have the condition of which I for no apparent reason, I will start coughing (uncontrollable) and randomly enough within a matter of seconds lose consciousness for approx. 30-50 secs (essentially pass out) obviously it scares my Family, co-workers & yes even Medical Staff have witnessed this. I take breathing treatments regularly have had antibiotics due to respiratory infection (Bronchitis, pneumonia etc.) I have no Insurance & not a BIG Fan of Obama Care (like I can afford that? Go figure) but nonetheless I I pay medical bills (out of pocket expense) any ideas?
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Answered by Dr. Michelle Gibson James (58 minutes later)
Brief Answer:
situational syncope

Detailed Answer:
Hi, thanks for using healthcare magic

The transient loss of consciousness may be called syncope (fainting).

The fact that it occurs in response to coughing would mean that it could be situational sycnope but other causes would need to be ruled out. In situational syncope, fainting occurs in this particular situation.
In addition to coughing, some persons may also have syncopal episodes in response to urination, bowel movements or , in some persons, swallowing.

It occurs as a result of widening of blood vessels (vasodilation) and temporary drop in pulse (Bradycardia).

Syncope can also occur from different causes- (1)abnormal heart rhythms (arrhythmias),
(2) orthostatic hypotension (drop in blood pressure on standing)
(3)cardiac ischemia-areas of the heart with reduced blood supply
(4)vasovagal- in response to pain, fear, distress

With a history of smoking, you are at risk of potential heart disease so these should be ruled out before it is considered to be situational.

This would involve heart tests such as stress testing and echo.

If the tests show that there are no heart issues and the syncope is due only to situational syncope then the main aspect of treatment is to reduce the coughing.

Coughing may be due to :(1) smoke related- COPD

(2)post nasal drip- the most common cause of persisting cough, may sometimes be silent.
Treated with a topical steroid nasal spray (eg flonase, nasocort, nasonex), anti histamines

Since this is the most common, you may want to consider treating this with above meds. Smoking cessation would also help.

(3)GERD

(4)asthma

(5)lesion in the lung

Summary: (1) may be situational syncope (fainting) but because smoking is a risk factor for heart disease, this needs to be ruled out

(2)may need to consider echo and stress test

(3)if situational only then need to reduce coughing as main aspect of treatment

(4)post nasal drip is the most common reason for persisting cough but may also be due to smoking related causes
Smoking cessation, nasal sprays and antihistamines may help

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16810 Questions

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Suggest treatment for severe cough and loss of consciousness

Brief Answer: situational syncope Detailed Answer: Hi, thanks for using healthcare magic The transient loss of consciousness may be called syncope (fainting). The fact that it occurs in response to coughing would mean that it could be situational sycnope but other causes would need to be ruled out. In situational syncope, fainting occurs in this particular situation. In addition to coughing, some persons may also have syncopal episodes in response to urination, bowel movements or , in some persons, swallowing. It occurs as a result of widening of blood vessels (vasodilation) and temporary drop in pulse (Bradycardia). Syncope can also occur from different causes- (1)abnormal heart rhythms (arrhythmias), (2) orthostatic hypotension (drop in blood pressure on standing) (3)cardiac ischemia-areas of the heart with reduced blood supply (4)vasovagal- in response to pain, fear, distress With a history of smoking, you are at risk of potential heart disease so these should be ruled out before it is considered to be situational. This would involve heart tests such as stress testing and echo. If the tests show that there are no heart issues and the syncope is due only to situational syncope then the main aspect of treatment is to reduce the coughing. Coughing may be due to :(1) smoke related- COPD (2)post nasal drip- the most common cause of persisting cough, may sometimes be silent. Treated with a topical steroid nasal spray (eg flonase, nasocort, nasonex), anti histamines Since this is the most common, you may want to consider treating this with above meds. Smoking cessation would also help. (3)GERD (4)asthma (5)lesion in the lung Summary: (1) may be situational syncope (fainting) but because smoking is a risk factor for heart disease, this needs to be ruled out (2)may need to consider echo and stress test (3)if situational only then need to reduce coughing as main aspect of treatment (4)post nasal drip is the most common reason for persisting cough but may also be due to smoking related causes Smoking cessation, nasal sprays and antihistamines may help I hope this helps, feel free to ask any other questions