Afib: Causes, Symptoms, and Treatment Options
Wet Coughs: What To Know
A wet, or productive, cough is a cough that brings up fluid, such as phlegm. It can indicate a respiratory infection, congestive heart failure, and other conditions.
In some cases, the type of cough a person has can help indicate its cause. This is because some underlying conditions produce mainly wet coughs, while others produce mainly dry coughs.
Read on to learn about some other differences between wet and dry coughs, as well as their potential causes. This article also outlines the various treatment options available for a wet cough.
Coughing is a reflex that occurs in response to irritation in the throat or lungs. It is the body's way of removing irritants such as fluid and phlegm.
A wet cough occurs when fluid in the airways triggers the coughing reflex. Since it produces phlegm, a productive cough is another name for a wet cough.
A wet cough can occur for a variety of reasons. Some potential causes include:
Sometimes, a wet cough is accompanied by other symptoms, such as:
These symptoms can provide a clue as to what is causing the wet cough.
Some typical causes of a wet cough include:
InfectionA wet cough often occurs as a result of a respiratory infection. Various types of respiratory infection can lead to an increase in mucus, including:
Other potential symptoms of a respiratory infection include:
BronchiectasisThe bronchial tubes carry air in and out of the lungs. Bronchiectasis is a condition in which the surface tissue of the bronchial tubes becomes thick, floppy, and scarred, with a widening of the tube diameter as a result of chronic inflammation. This results in excess mucus production, which can trigger a wet cough.
Some other potential symptoms of bronchiectasis include:
Chronic obstructive pulmonary disease (COPD) is an umbrella term for a group of chronic and progressive lung conditions. Some of these include:
Some forms of COPD cause damage to the tiny air sacs within the lungs, while others affect the bronchial tubes, the bronchioles, or both. Other symptoms of COPD include:
Congestive heart failure (CHF) occurs when the heart has difficulty pumping blood throughout the body. When this ineffective pumping occurs on the left side of the heart, it causes fluid to leak into the air sacs within the lungs. The result is a wet cough, crackles, and wheezing.
According to the American Heart Association (AHA), CHF may produce pink-tinged mucus. Some additional symptoms may include:
Various disease processes affect the lungs in different ways.
A dry cough differs from a wet cough in that it produces no fluid or mucus. It generally develops in response to irritation or inflammation of the airways.
Some common causes of a dry cough include:
According to the World Health Organization (WHO), the most common symptoms of COVID-19 are a dry cough, fever, and tiredness. In some people, however, coughing may produce sputum.
The symptoms of COVID-19 are usually mild and tend to begin gradually. Severe COVID-19 can lead to pneumonia. If a person develops pneumonia, they may develop a wet cough.
Instead of suppressing it, wet cough treatments typically aim to improve cough efficiency, thereby helping people clear the airways. Other treatments aim to clear phlegm and associated irritation in the back of the throat.
If the cough is due to an underlying medical condition, a doctor will prescribe specific treatments.
Treatments to improve cough efficiency and clear phlegmSome of the treatments below help improve cough efficiency. Others decrease mucus in the back of the throat, thereby reducing the need to cough.
Antibiotics can help treat a wet cough that occurs due to a bacterial infection. In these instances a person must finish the entire course of antibiotics as prescribed, even if symptoms improve before cessation of antibiotics.
In some cases, a wet cough may indicate a serious underlying health condition, such as a lung or heart condition. If a person is in any doubt as to the cause of their wet cough, they should make an appointment to see their doctor.
People should see a doctor as soon as possible if they experience any of the following symptoms alongside a cough:
Below are frequently asked questions relating to wet coughs.
Why do I have a wet cough with no other symptoms?There are many causes of a wet cough, ranging from viral infections to chronic lung problems. Not all causes of a wet cough cause additional symptoms.
How long should a wet cough last?Most coughs clear up independently within 4 weeks. However, a person's cough duration depends on the cause, health status, and treatments used.
Is a wet cough the end of a cold?A wet, productive cough is a hallmark symptom of a viral cold, but it does not necessarily indicate the end of the infection. Throughout a cold infection, the body produces mucus to trap viral bodies.
Does a wet cough need antibiotics?If the cause of a wet cough is a bacterial infection, then antibiotics can aid treatment and recovery.
Should you spit out phlegm?Spitting and swallowing phlegm are both safe and effective ways of clearing it from the respiratory system.
A wet cough occurs when excess fluid or mucus accumulates in the airways. It can be caused by respiratory infections, chronic lung conditions, or CHF.
Once a doctor has diagnosed the underlying cause of a wet cough, a person can begin appropriate treatment.
The treatment will depend partly on the cause of the wet cough. Medications such as mucolytics and expectorants can help remove mucus from the lungs. Antibiotics can help treat bacterial respiratory infections, while specific CHF medications will be necessary to treat the symptoms of heart failure.
Heat Exposure & Heart Stress; 2-Hour POC Troponin Assay; Colchicine After Stroke?
An experimental study showed that heat exposure increased myocardial blood flow to put stress on the heart, and some people showed asymptomatic heat-induced myocardial ischemia on imaging. (Annals of Internal Medicine)
Olfactory impairment was associated with incident congestive heart failure, but not coronary heart disease nor stroke, in older adults who were otherwise in good health. (Journal of the American Heart Association)
Even with plant-sourced foods, ultra-processing was linked to risks of cardiovascular disease and mortality, a U.K. Biobank study suggested. (Lancet Regional Health-Europe)
For patients with transthyretin cardiomyopathy, SGLT2 inhibitor treatment appeared safe and was associated with reduced heart failure events, according to an observational study. (Journal of the American College of Cardiology)
"Gut microbial age" may modulate cardiovascular health for metabolically unhealthy older people, researchers said. (Nature Medicine)
Dads in the U.S. Tended to have worse cardiovascular health compared with other men. (AJPM Focus)
The FDA said it is investigating Diamond Shruumz-brand Microdosing Chocolate Bars following reports of abnormal heart rates, hyper- and hypotension, seizures, and other illnesses among consumers.
Machine learning identified predictors of out-of-hospital cardiac arrest, both shockable and nonshockable. (Circulation)
Fewer people would be considered candidates for primary prevention statins based on the American Heart Association's PREVENT equations. (JAMA Internal Medicine)
A 2-hour point-of-care (POC) troponin assay was validated for emergency patients with suspected acute myocardial infarction. (European Heart Journal)
Emergency patients with chest pain and low detectable high-sensitivity cardiac troponin T concentrations may see increased long-term cardiovascular risks. (Heart)
Use of the MiRus Siegel 8-Fr aortic transcatheter heart valve was associated with good hemodynamics and 30-day clinical outcomes based on a handful of patients with severe, symptomatic aortic stenosis, MiRus announced.
In cases of failed fibrinolysis or contraindications to fibrinolysis, percutaneous transcatheter therapy with cerebral embolic protection appeared feasible for obstructive mitral mechanical valve thrombus. (Circulation: Cardiovascular Interventions)
How one center created the role of the full-time temporary mechanical circulatory support coordinator. (Circulation: Heart Failure)
The Heart Failure Association of the European Society of Cardiology released a clinical consensus statement on managing right heart failure following implantation of a left ventricular assist device. (European Journal of Heart Failure)
Some established cardiovascular prevention drugs may be repurposed to reduce the risk of aneurysmal subarachnoid hemorrhage. (Neurology)
The CONVINCE trial was stopped before investigators could show whether or not there are cardiovascular benefits of long-term colchicine use in stroke survivors. (The Lancet)
Recovering stroke survivors had better locomotor function when high-intensity training was paired with sessions of acute intermittent hypoxia, a small double-blind trial showed. (Stroke)
Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow
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Empagliflozin Does Not Decrease Risk Of Hospitalization Or Death After Myocardial Infarction
1. In this randomized controlled trial, empagliflozin was not shown to decrease the risk of hospitalization for heart failure or death among patients after acute myocardial infarction (MI).
2. Safety outcomes were generally similar between the empagliflozin and placebo groups.
Evidence Rating Level: 1 (Excellent)
Study Rundown: It is well-established that sodium-glucose cotransporter 2 (SGLT2) inhibitors such as empagliflozin improve cardiovascular outcomes in those with high-risk chronic diseases such as type 2 diabetes, kidney failure, or congestive heart failure. It has also been demonstrated that treatment with empagliflozin is associated with improved cardiac biomarkers such as natriuretic peptide concentration, left ventricular ejection fraction, and cardiac volume among patients who had an MI. However, no studies have directly assessed the clinical outcomes of SGLT2 inhibitor therapy after myocardial infarction. This study, EMPACT-MI, aimed to evaluate whether post-MI patients with a new reduction in left ventricular ejection fraction or symptoms of congestion would benefit from early treatment with empagliflozin. It was found that those who received empagliflozin had a similar risk of a composite primary endpoint (a first hospitalization for heart failure or death from any cause) compared to those who received a placebo. The two groups also had virtually identical safety outcomes; nearly one-quarter of both groups experienced a serious adverse event, and the same percentage had to discontinue the trial regimen. This study was limited by the lack of analysis of outpatient heart failure events, which may have made a meaningful contribution to the total disease burden. In addition, there was a lack of patient diversity, which may have limited the generalizability of the study findings. Overall, this study demonstrated that empagliflozin did not reduce the risk of first hospitalization for heart failure or death compared to placebo.
Click here to read the study in NEJM
In-Depth [randomized controlled trial]: This international, event-driven, double-blind trial involved adults who developed new signs of heart failure (left ventricular ejection fraction less than 45% or symptoms of congestion) after being hospitalized for an acute myocardial infarction. Participants were also required to have at least one additional enrichment factor, such as advanced age, type 2 diabetes mellitus, coronary artery disease, and chronic kidney disease. Eligible patients were randomly assigned in a 1:1 ratio to receive either 10mg of empagliflozin daily or a placebo in addition to standard care. The primary endpoint was a composite of hospitalization for heart failure or all-cause mortality. A total of 6,522 patients underwent randomization; 78.4% met the ejection fraction criterion, and 57.0% met the criteria for congestion. The median duration of follow-up was 17.9 months. A primary endpoint event occurred in 67 of 3260 patients (8.2%) in the empagliflozin group and 298 of 3262 patients (9.1%) in the placebo group (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.76 to 1.06; p=0.21). However, the group that received empagliflozin did appear to have a lower risk of having a first hospitalization for heart failure (HR, 0.77; 95% CI, 0.60 to 0.98) as well as fewer hospitalizations for heart failure overall (HR, 0.67; 95% CI 0.51 to 0.89). The two groups had similar serious adverse events (23.7% in the treatment group versus 24.7% in the placebo group) and adverse events leading to discontinuation of the trial regimen (3.8% in both groups). In summary, these results show that empagliflozin was comparable to placebo for reducing hospitalizations for heart failure and mortality in patients with acute myocardial infarction.
Image: PD
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