Cough-Variant Asthma: Symptoms, Causes, Treatment

What are the symptoms of cough-variant asthma?

Cough-variant asthma (CVA) is a type of asthma that presents with a persistent cough as the primary symptom, often without wheezing or other traditional asthma symptoms. The symptoms of CVA can be subtle and may not be immediately recognized as asthma. Here are some common symptoms of CVA:

1. Persistent cough: A dry, hacking, or irritating cough that persists for weeks, months, or even years. The cough may be worse at night, and it may be triggered by lying down or being in an upright position.
2. Coughing without wheezing: Unlike typical asthma, CVA patients often do not experience wheezing, which is a common symptom of asthma.
3. Coughing without shortness of breath: CVA patients may not experience shortness of breath (dyspnea), another common symptom of asthma.
4. Coughing without chest tightness: Chest tightness or constriction is a common symptom of asthma, but it is often absent in CVA patients.
5. Coughing triggered by exposure to allergens or irritants: Exposure to allergens like dust mites, mold, or pet dander, as well as irritants like smoke, pollution, or chemicals, may trigger the cough in CVA patients.
6. Coughing triggered by exercise or physical activity: Exercise or physical activity may trigger the cough in some CVA patients.
7. Coughing worse at night: CVA patients may experience a worsening of their cough symptoms at night, making it difficult to sleep.
8. Coughing with nasal congestion: Some CVA patients may experience nasal congestion or stuffiness, which can contribute to the cough.
9. Coughing with postnasal drip: Postnasal drip, also known as posterior nasal drip, is the sensation of mucus running down the back of the throat. This symptom can be present in CVA patients.
10. Fatigue and sleep disturbance: The persistent cough can lead to fatigue and sleep disturbance, which can affect daily life and quality of life.

If you suspect you have CVA, it’s essential to consult a healthcare professional for proper diagnosis and treatment. A thorough evaluation will include a physical exam, medical history, and diagnostic tests to rule out other conditions that may cause similar symptoms.

What are the causes of cough-variant asthma?

Cough-variant asthma (CVA) is a type of asthma that presents with a persistent cough as the primary symptom, often without wheezing or other traditional asthma symptoms. The causes of CVA are not fully understood, but several factors may contribute to its development:

1. Allergies: Allergies to inhalant allergens, such as dust mites, mold, or pet dander, can trigger coughing in CVA patients.
2. Irritants: Exposure to irritants like tobacco smoke, pollution, or chemicals can trigger coughing in CVA patients.
3. Gastroesophageal reflux disease (GERD): GERD can cause stomach acid to flow up into the esophagus, irritating the airways and triggering coughing.
4. Postnasal drip: Postnasal drip, or the sensation of mucus running down the back of the throat, can irritate the airways and trigger coughing.
5. Sinusitis: Chronic sinusitis can cause nasal congestion and postnasal drip, leading to coughing.
6. Respiratory infections: Respiratory infections like bronchitis or pneumonia can cause inflammation in the airways and trigger coughing.
7. Environmental factors: Exposure to environmental factors like cold air, humidity, or pollution can trigger coughing in CVA patients.
8. Genetic predisposition: Some people may be more prone to developing CVA due to genetic factors.
9. Hormonal changes: Hormonal changes during pregnancy, menstruation, or menopause can affect the airways and trigger coughing in some individuals.
10. Anatomical factors: Anatomical abnormalities, such as a deviated septum or nasal polyps, can cause nasal congestion and postnasal drip, leading to coughing.
11. Smoking: Smoking is a known risk factor for developing CVA.
12. Other medical conditions: Certain medical conditions, such as gastroesophageal reflux disease (GERD), chronic bronchitis, or chronic obstructive pulmonary disease (COPD), can increase the risk of developing CVA.

It’s essential to note that CVA is often misdiagnosed as chronic bronchitis or chronic obstructive pulmonary disease (COPD). A thorough evaluation by a healthcare professional is necessary to determine the underlying cause of the cough and develop an appropriate treatment plan.

What is the treatment for cough-variant asthma?

The treatment for cough-variant asthma (CVA) is similar to that of traditional asthma, but with a focus on relieving coughing symptoms. The goal of treatment is to reduce coughing, improve lung function, and prevent future exacerbations. Here are some common treatment options for CVA:

1. Inhaled corticosteroids: Inhaled corticosteroids, such as fluticasone (Flovent) or budesonide (Pulmicort), are commonly used to treat CVA. They help reduce inflammation in the airways and prevent coughing.
2. Long-acting bronchodilators: Long-acting bronchodilators, such as salmeterol (Serevent) or formoterol (Foradil), can help relieve coughing symptoms by relaxing the airway muscles.
3. Combination inhalers: Combination inhalers that contain both a corticosteroid and a bronchodilator, such as fluticasone-salmeterol (Advair) or budesonide-formoterol (Symbicort), can be effective in treating CVA.
4. Mucolytics: Mucolytics, such as acetylcysteine (Mucomyst), can help break down mucus in the airways and reduce coughing symptoms.
5. Expectorants: Expectorants, such as guaifenesin (Mucinex), can help loosen and clear mucus from the airways.
6. Cough suppressants: Cough suppressants, such as dextromethorphan (Robitussin), can help relieve coughing symptoms at night or when the patient is not experiencing an exacerbation.
7. Antihistamines: Antihistamines, such as diphenhydramine (Benadryl), can help relieve coughing symptoms caused by allergies.
8. Gastroesophageal reflux disease (GERD) medications: If GERD is contributing to the coughing symptoms, medications such as proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) may be prescribed to help reduce acid reflux.
9. Avoidance of triggers: Identifying and avoiding triggers, such as allergens, irritants, or environmental factors, can help reduce coughing symptoms.

It’s essential to work with a healthcare provider to develop a personalized treatment plan that addresses the specific needs of the patient. Additionally, patients with CVA may need to take medications regularly to maintain control of their symptoms and prevent exacerbations.