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Old 06-17-2012
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Question Three Differential Diagnoses of Nocturnal Cough?

there are 3 causes of nocturnal cough

Asthma
GERD
CHF

how can we differentiate on these based on history ?

regarding GERD, i know it will be 1-2 hours after lying down in bed.
what about asthma and GERD ? i cant clearly remember but there is something early AM cough in asthma.... please help..its imp for ck as far i know.
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Old 06-17-2012
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GERD---
increased by lying down..
decreased by sitting up.
associated with --burning sensation in chest/bad taste in mouth
(no wheezing, breathing difficulty classically)


CHF--
wet cough.
classic presentation of orthopnea or PND, plus other symptoms of CHF
(really not all that hard to differentiate)


asthma--
Nocturnal wheezing, cough, and trouble breathing
no positional changes... not better with sitting up etc.


note--
chronic night time GERD can predispose to asthma.. by causing laryngeal irritation and bronchospasm.
also use of Beta agonists for asthma might predispose you to GERD.
so you might have both together.
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Old 06-17-2012
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AM cough in Asthma is due to increased bronchial tone in early AM hours.
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Cardiology-, Gastroenterology-, Internal-Medicine-, Pulmonology-

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