Five common symptoms of respiratory diseases

The five most common symptoms of respiratory diseases are cough, sputum production, dyspnea (also commonly known as chest tightness and shortness of breath), chest pain, and hemoptysis. As a clinical worker who has worked in the respiratory department for three years, I have seen too many people treat these early signs as a common cold and wait until they become seriously ill to seek medical treatment. I have also encountered many people who have just accepted the popular science on the Internet and frightened themselves for a long time before checking.

Last week, I met a 22-year-old college student in the clinic. He coughed for three consecutive days after returning from an autumn trip. He bought a powerful antitussive syrup and drank it. The cough stopped, but he started to have a low fever and was short of breath. When he came for a CT scan, it was found that it was mycoplasma pneumonia, and there were small pieces of infiltration in his lungs. At present, there are indeed different clinical ideas for the treatment of cough: Western medicine generally does not recommend the use of powerful antitussives as soon as a cough is present, especially when there is phlegm. Blind coughing will block secretions in the airway, which will aggravate the infection. Only when the dry cough seriously affects sleep and daily work, short-term antitussives will be used for relief. ； Traditional Chinese medicine will first distinguish between cold cough, hot cough, and wind cough. For example, for cough with white and thin phlegm caused by cold, using prescriptions that warm the lungs is more effective than simply relieving cough. You can choose according to your own situation, but if the cough does not relieve for more than 3 days, don’t force it.

Many people will produce phlegm when they cough. The phlegm with different characteristics is actually equivalent to the "little note of illness" sent to you by the respiratory tract. You don't have to hold it in and dare not spit it out. What particularly impressed me was the 68-year-old man who took care of me last month. He coughed up rust-colored phlegm for a week and thought he had a fever. He drank a lot of honeysuckle tea. When he arrived, his fever reached 39 degrees. He was diagnosed with Streptococcus pneumoniae infection. Generally speaking, yellow purulent sputum mostly indicates bacterial infection, and white foamy sputum may indicate viral infection or chronic bronchitis. If you cough up pink foamy sputum, don’t hesitate to go to the emergency room immediately. This is most likely a sign of acute left heart failure involving the respiratory tract, so there is no need to delay it.

When many patients progress, the first thing they feel is that their chest feels like half a piece of wet cotton is pressing down on them. They usually have no trouble climbing the third floor, but now they have to stop and gasp for breath after walking a hundred meters. In severe cases, they can’t even breathe while sitting still, and the tips of their lips and fingernails are blue—this is dyspnea among the five major symptoms. Nowadays, many people will have shortness of breath after activities for one or two months after being infected with COVID-19 and influenza A. Whether it matters or not is a question currently discussed in the academic circles: some scholars believe that this is just a high airway reaction after infection, and there is no organic damage. If you rest more and don't exercise strenuously, you can recover on its own in two or three months. ； Some studies have also suggested that this type of long-term shortness of breath may be related to minor interstitial lung damage and myocardial involvement. Therefore, if this situation does not resolve for more than 1 month, it is best to have a lung function and chest CT examination to reassure you.

There are also many people who experience chest pain when they have a severe cough. When they inhale or cough, their chest hurts, and even their back hurts. This is mostly caused by inflammation involving the pleura. Every time I meet a patient who complains of chest pain, I will ask two more questions: If the pain is a dull, squeezing feeling, with left shoulder or gum pain, and the pain has nothing to do with breathing, then I will first ask him to check an electrocardiogram to rule out myocardial infarction, and don't confuse it with respiratory problems. This is also our clinical experience. After all, the two problems have completely different priorities.

The most panicked thing is hemoptysis. I have seen more than one patient cough up a little blood and sit in the corridor of the clinic with a pale face, thinking that he had lung cancer. In fact, a small amount of bloodshot is mostly caused by coughing too violently and tearing the airway mucosa, so there is no need to panic at all. ； But if there is blood all over the mouth, or if there is blood in the sputum repeatedly for more than a week, you must be alert to the possibility of bronchiectasis, tuberculosis, and lung cancer and have it checked in time. Here I would like to remind everyone that if hemoptysis occurs, do not hold back and cough. Try to cough up the blood. Otherwise, blood clots blocking the airway can easily cause suffocation. This is the highest clinical risk to avoid.

In fact, these five symptoms rarely appear alone. They often appear in combination with two, three or more. Everyone’s body is different, and the degree of manifestation is also very different. There is no need to “sentence” yourself against the symptoms, and don’t ignore them. If you really feel uncomfortable, seeing a professional doctor is much more useful than searching for terms online for half a day.