Cough reflex by ventricular premature contractions.
A 72-year-old man was referred for further assessment of a chronic cough. He noticed an association between the episodes of coughing and palpitations. Electrocardiography (ECG) revealed normal sinus rhythm and sporadic unifocal ventricular premature contractions (VPCs). Each cough was preceded by a premature beat. Continuous wave Doppler echocardiography revealed a VPC-induced transient increase in the pulmonary artery blood flow. He was successfully treated for VPCs with oral disopyramide, resulting in subsidence of both the coughing and palpitations. We suspect that the VPC-induced hemodynamic changes in the pulmonary circulation might be responsible for coughing in our patient. Premature contractions should be considered as a possible cause of chronic dry cough in the clinical setting.
Niimi
Akio
A
Division of Respiratory Medicine, Kyoto University Hospital, Japan.
Kihara
Yasuki
Y
Sumita
Yoshiyuki
Y
Okano
Yoshiaki
Y
Tambara
Keiichi
K
Fujita
Masatoshi
M
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003371:Cough / Q000209:etiology*; D004206:Disopyramide / Q000627:therapeutic use; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D004206:Disopyramide