A fifteen-year-old female presents to your clinic complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately, she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema, and her father has high blood pressure. She is the only child. She denies smoking and illegal drug use. On examination, she is in no acute distress and her vital signs are: T 98.6, BP 120/80, pulse 80, and respirations 20. Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.

1. What is the chief complaint?
2. Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?
3. What treatment plan would you consider utilizing current evidence based practice guidelines?

ADDITIONAL INSIGHTS

Shortness of breath and a nonproductive nocturnal cough

Introduction

Long-term smokers are more likely than nonsmokers to experience shortness of breath and early death. This is true even after controlling for other factors such as age, heart disease, and high blood pressure. Researchers also note that some people who smoke may never develop cancer because they have a lower risk of lung cancer when they quit smoking than people who continue smoking.

Shortness of breath

Shortness of breath can be caused by many things. Breathing problems can be caused by asthma, allergies and smoking. Breathing problems can also be caused by pneumonia and cancer.

Breathing problems

Shortness of breath and a nonproductive nocturnal cough can be caused by a number of different health issues. One of the most common is asthma, which is when the airways in your lungs become irritated and swollen. This can cause wheezing, coughing and chest tightness. Other causes include chronic bronchitis or emphysema (a condition where there’s damage to the tissues lining your lungs), pneumonia (an infection) and allergies that interfere with breathing through the nose or mouth while sleeping.

Chronic cough

Chronic coughs can be caused by a number of different things. Smoking is the most common cause, but allergies and asthma are also known to cause chronic coughing. A chronic cough may also be caused by pneumonia or cancer if it’s not treated properly.

If you’re having trouble breathing in your sleep because of a chronic cough, talk to your doctor about what treatment options are best for you.

Coughs can be caused by many things, including asthma or allergies.

Some coughs are caused by allergies, asthma or lung infections. It’s important to rule out these conditions before you go on to the next step in your treatment plan. If you have a history of smoking, this can also be a factor in your coughs.

You may have noticed that when you wake up with a dry throat and hoarse voice after having slept through the night without waking up once – it could be due to poor air quality near bedtime time due to concentrations of dust particles in homes near roads where traffic flows through during peak hours (rush hours). These particles irritate nasal passages which leads then into coughing as well as other symptoms like nasal congestion etc.,

Coughs can be caused by pneumonia.

Coughs can be caused by pneumonia. Pneumonia is a lung infection, and it’s usually caused by bacteria or viruses. Symptoms include shortness of breath, fever, and cough; if you have these symptoms for more than 10 days in a row, see your doctor.

Pneumonia can be treated with antibiotics but may require hospitalization if you have other health problems like heart disease or diabetes that make it harder for your body to fight off bacterial infections (like flu).

They can be caused by certain cancers.

While shortness of breath and coughs can be caused by lung cancer, it’s important to note that they are not the only cause. Lung cancer is the leading cause of cancer death in the United States and many other countries around the world.

It’s also more common among smokers than non-smokers, who tend to be older people with a history of smoking (like your mom).

Lung cancer can be treated and cured if caught early enough—but only if you take action now!

Smoking can cause chronic coughs.

Smoking is a leading cause of chronic coughs. Coughing that persists for more than two weeks can be a sign of bronchitis or emphysema, which are serious conditions that affect the lungs. If you have one of these diseases and continue to smoke, your ability to breathe will become impaired over time—and it could lead to complications such as pneumonia or heart attacks.

If you’re trying to quit smoking but haven’t been able to do so yet, talk with your doctor about quitting cold turkey (without nicotine replacement therapy). You can also try using medicines such as varenicline (Chantix) or bupropion hydrochloride (Zyban)—but keep in mind that these medications may not work well if there’s another underlying condition causing your problem!

Conclusion

Shortness of breath, coughing and wheezing can be a sign of something more serious. Your doctor may want you to have tests done to find out what’s going on with your symptoms.