Shortness of breath and cough
Pro Research Analysisby 
Searched over 200M research papers
Consensus Meter
Shortness of Breath and Cough: Causes, Symptoms, and Management
Prevalence and Impact in Palliative Care
Shortness of breath and cough are prevalent and distressing symptoms in patients receiving palliative care. These symptoms affect 10% to 70% of patients with advanced cancer and 60% to nearly 100% of patients with non-malignant diseases, depending on the specific condition. Effective management of these symptoms is crucial for improving the quality of life in palliative care settings.
Common Causes and Conditions
Advanced Cancer and Non-Malignant Diseases
Patients with advanced cancer frequently experience shortness of breath and cough due to tumor growth, treatment side effects, or associated infections. Non-malignant conditions such as chronic obstructive pulmonary disease (COPD), heart failure, and interstitial lung diseases also contribute significantly to these symptoms.
Acute and Chronic Infections
Infections are a common cause of cough and shortness of breath. For instance, a 67-year-old woman developed these symptoms after immigrating to the United States, which were initially treated with antibiotics without success, indicating a possible chronic or resistant infection. Similarly, a 32-year-old man with eosinophilic pneumonia experienced persistent symptoms despite multiple antibiotic courses, highlighting the complexity of diagnosing and treating respiratory infections.
Asthma and Allergic Conditions
Asthma is a well-known cause of cough and shortness of breath. A study on schoolchildren found that wheeze and shortness of breath were prevalent, with a significant association with asthma. Additionally, a 68-year-old man with steroid-dependent asthma exhibited persistent symptoms despite treatment, underscoring the chronic nature of asthma and the need for ongoing management.
Diagnostic Challenges
Complex Cases
Diagnosing the underlying cause of cough and shortness of breath can be challenging, especially in complex cases. For example, a 48-year-old woman with metastatic breast cancer presented with acute symptoms, which required thorough evaluation to rule out complications related to her cancer and recent biopsy. Another case involved a 17-year-old male with a history of mild asthma and a family history of pulmonary alveolar proteinosis, presenting with severe respiratory symptoms, necessitating a detailed diagnostic workup.
Management Strategies
Non-Pharmacological Interventions
Several non-pharmacological measures can help alleviate shortness of breath and cough. These include reassurance, development of an emergency plan, physical activity, and relaxation exercises. Supportive measures such as using a rollator, cool air drafts from a handheld fan, physiotherapy, and respiratory therapy have shown effectiveness.
Pharmacological Treatments
Opioids are the medications of choice for managing these symptoms in palliative care due to their proven efficacy. Benzodiazepines are often used, although their benefit is not statistically significant. Expectorants can aid patients with productive cough, while antitussants like morphine and dextromethorphan are effective in suppressing the cough reflex with low toxicity.
Conclusion
Shortness of breath and cough are common and distressing symptoms with various underlying causes, including advanced cancer, chronic infections, asthma, and other respiratory conditions. Effective management requires a combination of non-pharmacological and pharmacological interventions tailored to the individual patient's needs. Accurate diagnosis and appropriate treatment are essential for improving patient outcomes and quality of life.
Sources and full results
Most relevant research papers on this topic