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Diagnosis and Management of Premature Ventricular Complexes-Associated Chronic Cough.
Chest. 2009 Mar 24;
Authors: Stec SM, Grabczak EM, Bielicki P, Zaborska B, Krenke R, Krynski T, Dabrowska M, Domagala-Kulawik J, Domeracka-Kolodziej A, Sikorska A, Kulakowski P, Chazan R
Background Chronic cough may frequently remain unexplained. Although various cardiac arrhythmias have already been reported as a cause of chronic cough, this phenomenon has not been evaluated prospectively. Therefore we studied the incidence and management of cough associated with premature ventricular complexes (PVC) in a population of patients with PVCs. Methods Patients without organic heart disease, referred for management of symptomatic PVC, were evaluated prospectively. PVC-associated cough was recognized if cough episodes occurred just after spontaneous or induced PVC, observed in ECG or a multichannel recording system including ECG. Differential diagnosis of cough was performed according to the guidelines on cough. Afterwards, antiarrhythmic therapy was instituted to achieve disappearance of PVC and cough. Results Of 120 patients referred for management of PVCs, 10 had a chronic cough. After extensive workup for the cause of chronic cough, the cough was thought to be solely due to PVCs in one, partially due to PVCs plus another cause in five, and not due to PVCs in four patients. In this last group, the cause of cough was nonasthamtic eosinophilic bronchitis, gastroesophageal reflux disease and chronic sinusitis. Patients with PVC-associated cough reported more severe perception of symptoms associated with arrhythmia as compared to patients without cough (Visual Analog Scale: 8.2 +/- 0.5 vs 5.7 +/- 1.6, p < 0.01). PVC-associated cough disappeared after antiarrhythmic treatment (radiofrequency ablation (n = 4), oral antiarrhythmic agent (n = 1)), or after spontaneous remission of PVC (n = 1). Conclusions PVC may be a cause of chronic cough. Interdisciplinary cooperation is warranted for proper diagnosis and management of PVC-associated cough.
PMID: 19318662 [PubMed - as supplied by publisher]