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What causes coughing with chest pain?

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Posted on Tue, 15 Jul 2014
Question: Hello,
I have been suffering from coughing and mild chest pain for almost 2.5 months. Upon checking with my doctor, he ordered an X-ray which revealed prominent bronchovascular markings bilaterally. A CT scan also reveled no masses but minimal bilateral pleural effusion.

Would this be related to Bronchitis? What is your eecommendation?
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
May not be related to bronchitis.

Detailed Answer:
Hi.
Thanks for your query.
Coming directly to the question: Would this related to bronchitis ?
Minimal bilateral pleural effusion can just be a reactionary in nature, secondary to coughing, inflammation of the lungs; it is just minimal as per CT scan, so can not be tapped ( removed ) for analysis.

You have coughing for 2.5 months and only mild chest pain.
Please tell me whether:
there is production of phlegm ( expectoration), if yes, how much is the quantity, color?
Fever?
breathlessness?
increasing factors?
reducing factors?
any other medical problem- particularly diabetes, hypothyroidism? weight loss, loss of appetite, evening rise of temperature, listlessness by evening ?

Recommendations:
Blood tests: Complete blood picture, blood sugar, urea, creatinine, thyroid function tests, ESR,
Mantoux-
If there is loss of weight and appetite, Quantiferon gold test for TB.
If phlegm- gram staining, AFB staining, culture and sensitivity.
If all the tests are negative and clinically if your Doctor feels it is either asthma or just allergic phenomenon, Symptomatic treatment according to the findings.

Remember a clinical examination and particularly auscultation by stethoscope by a good clinician / Pulmonologist can detect the disease better than any tests. So an opinion of a Pulmonologist should be sought. HE can also conduct pulmonary function tests.

Keep away from all the allergens which you must have noticed to increase your problem. Wet dusting in the house/ office. No pets, vacum cleaning of the beds and sofas.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. T Chandrakant (6 hours later)
Thank you so much for your answer. Please note the following
My coughing is producing phlegm which is generally white with some yellow or green. There is no blood what so ever. There is no fever, no weight loss or loss of appetite. Generally, I feel much better than how it was couple of months ago, but not 100% back to normal. I breath normally, but just feels chest discomfort and as if their is weight on my chest.

I have done a full blood picture couple of days ago as part of an annual check up. There is no diabetes, urea creatinine and thyroid are all normal. LDL is a border line but as before and nothing new here.

Thanks and looking forward for your advice.

doctor
Answered by Dr. T Chandrakant (5 hours later)
Brief Answer:
Gram staining C/S of phlegm.

Detailed Answer:
Thanks for your feedback and good to know the reports.
The phlegm which is white with some yellow or green is indicative of an active infection.
This has to be sent for Gram Staining, culture and sensitivity ( C/S).
This report will help the right choice of antibiotic/s to be given over till the phlegm becomes colorless ( clinical/ your finding) and to be continued for an extended period to have a cure. IT may be from one to many weeks.
The phlegm is produced in response to the infection and inflammation of the mucosa
So it will take some time to settle till the mucosal lining is healed. Takes time.

Addition of Vitamin A and D in therapeutic doses helps a lot for regeneration of mucosa, as is to continue anti-oxidants ( multi-vitamins) along with antibiotics under your Doctor's advise.
Plain water steam inhalations 2 to 4 times a day help to loosen the phlegm, increase the coughing to expel out the phlegm helps to improve airway diameter so that feeling of discomfort and heaviness usually can go away.

I hope you are not exposed to the irritants in the nature of smoke, scents, fumes or over-pollution.
Take care, follow this advise and I hope you should be fine soon and cured too.
You do not have to depend upon X-ray / CT scan findings.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 18949 Questions

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What causes coughing with chest pain?

Brief Answer: May not be related to bronchitis. Detailed Answer: Hi. Thanks for your query. Coming directly to the question: Would this related to bronchitis ? Minimal bilateral pleural effusion can just be a reactionary in nature, secondary to coughing, inflammation of the lungs; it is just minimal as per CT scan, so can not be tapped ( removed ) for analysis. You have coughing for 2.5 months and only mild chest pain. Please tell me whether: there is production of phlegm ( expectoration), if yes, how much is the quantity, color? Fever? breathlessness? increasing factors? reducing factors? any other medical problem- particularly diabetes, hypothyroidism? weight loss, loss of appetite, evening rise of temperature, listlessness by evening ? Recommendations: Blood tests: Complete blood picture, blood sugar, urea, creatinine, thyroid function tests, ESR, Mantoux- If there is loss of weight and appetite, Quantiferon gold test for TB. If phlegm- gram staining, AFB staining, culture and sensitivity. If all the tests are negative and clinically if your Doctor feels it is either asthma or just allergic phenomenon, Symptomatic treatment according to the findings. Remember a clinical examination and particularly auscultation by stethoscope by a good clinician / Pulmonologist can detect the disease better than any tests. So an opinion of a Pulmonologist should be sought. HE can also conduct pulmonary function tests. Keep away from all the allergens which you must have noticed to increase your problem. Wet dusting in the house/ office. No pets, vacum cleaning of the beds and sofas.