APPROACH TO THE
CHRONIC COUGH
CHRONIC COUGH (more than 8 weeks)
History and Physical Exam Obvious
source identified
Cough Resolved Stop
ACE Inhibitor (4-6 weeks)
Stop Smoking (4-6 weeks)
Cough Persists
Obtain Chest Radiograph and
Pulmonary Function tests
Abnormal
Further
work-up Minimal
abnormality on imaging likely
not
related to cough Cough persists
(ie
small granuloma)
CHRONIC COUGH WITH
Evaluate and treat for the most
common conditions
Post-Infectious Cough
*Observe
*inhaled
versus oral steroids
Upper
Airway Cough Syndrome ASTHMA GERD
(Rhinitis/Post
nasal drip/Sinus disease) *PFTs *Lifestyle mod
*Antihistamines/
Decongestants *Inhaled steroids *PPI
*Nasal
Steroids *Inhaled broncho- *H2 blocker
*Sinus
imaging if no improvement dilators
*Oral steroids
Cough Persists
Evaluate for less common causes