Chest Pain and Persistent Cough After a Cold

Q: Chest Pain and Persistent Cough After a Cold

Hello： The presence of significant pain points makes the likelihood of lung issues lower. <br>Low-dose computed tomography is used for screening early lung tumors; however, at 26 years old, and without a family history, it is currently not recommended. <br>Nevertheless, if the pe

Pain with deep breathing?

Hello Doctor: Last month, after having a cold, I have been experiencing a persistent itchy throat and dry cough for the past month.
I have taken both Western and Chinese medicine, which have slightly alleviated the cough, but I still have a dry cough.
When I take a deep breath, I feel pain in the middle right side of my chest, and I can pinpoint the pain.
It hurts when I cough or sneeze, and bending over or turning my neck also causes pain.
I had an X-ray at the hospital during this period, and the doctor said my lungs are normal.
It may be that the cough discomfort in my throat is caused by gastroesophageal reflux that occurred at the beginning of the month.
I also had an endoscopy, and both my esophagus and stomach are normal.
I have a history of asthma and allergies, and I do not smoke or drink.
I have been on a long-term prescription for Allegra (Fexofenadine HCl 60mg) and Carbinoxamine maleate (2.5mg).
Since my symptoms have persisted for a month with no significant improvement in cough and chest pain, and the cough is intermittent, my neck is also very stiff and sore, and I feel a dull discomfort in my chest muscles.
Could you please advise if the chest symptoms are due to chest wall pain or costochondritis? Additionally, should I return to a pulmonologist for a self-paid low-dose chest CT scan, or should I seek a diagnosis from another clinic? Thank you for your response, Doctor.

DoDo, 20~29 year old female. Ask Date: 2016/11/15

Dr. Jian Shuntian reply Pulmonology

Hello: The presence of significant pain points makes the likelihood of lung issues lower.
Low-dose computed tomography is used for screening early lung tumors; however, at 26 years old, and without a family history, it is currently not recommended.
Nevertheless, if the persistent pain has not been attributed to a specific cause, close monitoring is still necessary.
Please follow up with the thoracic department for continued evaluation.
Thank you.

Reply Date: 2016/11/15

More Info

Understanding chest pain and persistent cough after a cold can be quite complex, especially when symptoms linger for an extended period. Based on your description, it seems you have been experiencing a combination of throat irritation, dry cough, and localized chest pain for about a month following a cold. You have also undergone X-rays and an endoscopy, which returned normal results for your lungs and gastrointestinal tract.
The persistent dry cough and chest pain you are experiencing could be attributed to several factors. One possibility is that your cough is a residual effect of the upper respiratory infection you had. Coughing can irritate the muscles in the chest wall, leading to pain that is exacerbated by movements such as bending or twisting. This type of pain is often referred to as "musculoskeletal pain" and is generally benign.
Another potential cause of your symptoms could be related to gastroesophageal reflux disease (GERD), especially since you mentioned a history of gastroesophageal reflux. GERD can lead to chronic cough due to the irritation of the throat and airways from stomach acid. This irritation can also cause a sensation of tightness or pain in the chest, particularly when you cough or sneeze.

Given your history of asthma and allergies, it is also important to consider that your respiratory symptoms could be exacerbated by these conditions. Asthma can cause chronic cough and chest tightness, especially if you are exposed to allergens or irritants. The medications you are taking, such as Fexofenadine and Carbinoxamine, are antihistamines that can help manage allergic symptoms but may not fully address underlying asthma-related issues.

Since your symptoms have persisted for a month without significant improvement, it would be prudent to follow up with a healthcare provider, particularly a pulmonologist or an allergist. They may recommend further evaluation, such as a low-dose CT scan of the chest, to rule out any underlying conditions that may not have been visible on the initial X-ray. Additionally, pulmonary function tests could help assess your asthma control and determine if your current medications are adequate.

In the meantime, consider implementing some lifestyle modifications that may alleviate your symptoms. For instance, avoiding known allergens, maintaining good hydration, and using a humidifier can help soothe your throat and reduce coughing. If you suspect that GERD is contributing to your symptoms, avoiding large meals, spicy foods, and lying down immediately after eating can be beneficial.

In summary, while your symptoms may be related to post-viral cough, musculoskeletal pain, or GERD, it is essential to consult with a healthcare professional for a thorough evaluation and tailored treatment plan. Persistent symptoms warrant further investigation to ensure that no underlying conditions are contributing to your discomfort.

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