Five common symptoms of respiratory diseases

The five common core symptoms of respiratory diseases are cough, sputum production, dyspnea, chest pain, and hemoptysis. They are the core reference indicators for clinical screening and judging the severity of respiratory lesions.

During the two years when I rotated in the respiratory clinic, when the temperature dropped during the change of seasons, at least 20 of the 30 people in the morning came in coughing. Don’t underestimate the symptoms of cough. It is essentially a self-protection mechanism of the respiratory tract. Invading pathogens, dust, and secretions must be expelled through coughing. However, many people’s treatment of coughs is completely polarized: one group believes that "coughing is about coughing up phlegm, and it absolutely cannot relieve the cough." In fact, clinical practice has long been no longer so absolute: if it is a dry cough without phlegm, which has seriously affected sleep and daily work, it is perfectly fine to use antitussives appropriately; but if it is a wet cough with a lot of sputum, it is really not recommended to use powerful central antitussives. The key is to give priority to using phlegm-reducing drugs to expel secretions. Last week, a little girl had a cough for almost three weeks after having the flu. The CT scan was all normal. She was so scared that she thought she had lung cancer. In fact, it was a hyperresponsiveness of the airway after infection. Like skin allergies, the airway was easily "twitched" when it was irritated. She slowly recovered after taking some anti-allergy medicine.

Sputum production is often associated with coughing. Many people have a deep-rooted belief that "white phlegm is a cold, yellow phlegm is a bacterial infection, and you need to take antibiotics." This is also one of the most controversial points in clinical practice today: In the early years, primary medical care did use yellow phlegm as an indication for antibiotics, but the latest domestic and foreign guidelines clearly mention that in the later stages of viral infection, the remains of immune cells and pathogens after fighting are mixed in the secretions to form yellow phlegm, and there is no need to take antibiotics at all. We now generally recommend that patients have their blood routine and C-reactive protein checked first to confirm evidence of bacterial infection before taking medication to avoid drug resistance problems caused by the misuse of antibiotics. When I go to the outpatient clinic, I often encounter patients who have taken cephalosporin for three or four days at home and have not recovered. After a check, it is not a bacterial infection at all, and they suffer in vain.

If the first two symptoms can still be treated with the mentality of "drinking more hot water and getting through it", when it comes to difficulty breathing, most people will take the initiative to come to the hospital. Only those who have experienced this feeling can understand: after climbing two floors, I feel like I am breathing from a bellows, and my throat feels like a half-blocked whistle. The air I breathe in always feels like there is not enough. In severe cases, when I lie down at night, I am so suffocated that I have to sit up and sleep on the pillow. Every winter, most of the chronic bronchitis and chronic obstructive pulmonary patients admitted to the respiratory department inpatient department suffer from unbearable breathing. Oh, by the way, I want to say one more thing here. Not all dyspnea is a lung problem. Patients with heart failure will also have paroxysmal dyspnea at night. We will identify it first during clinical consultation to avoid missing the diagnosis of heart problems.

Patients with chest pain are generally panicked when they come in. After all, everyone now knows that chest pain may be a myocardial infarction, and the first reaction is to call the emergency room. There was a young man in his twenties who got pneumonia after staying up late. His chest hurt when he coughed, and the pain was more obvious when he took a deep breath. He was so frightened that he called 120 to send him over. The electrocardiogram was all normal, which means that the pneumonia has affected the pleura. Unlike cardiac chest pain, respiratory-related chest pain is mostly related to breathing and coughing movements. The location of the pain is generally relatively fixed and does not radiate to the back or left arm like myocardial infarction. Of course, this is only a preliminary judgment. As long as unexplained chest pain occurs, it is definitely right to go to the hospital as soon as possible.

Finally, when it comes to hemoptysis, many people are scared out of their wits when they cough up some blood. Their first reaction is "Am I suffering from lung cancer?" In fact, most of the small amounts of blood-streaked sputum are caused by coughing too hard and rupturing the small mucous membrane in the throat, just like picking your nose and causing bleeding. It is not that scary. Common bronchiectasis, tuberculosis, and pneumonia may cause hemoptysis. But if it’s a mouthful of bright red blood, or even less than half a cup of blood, don’t delay. Call 120 and send him to the emergency department immediately. Severe hemoptysis can cause suffocation if the airway is blocked.

Of course, these five symptoms never appear in isolation. Many patients with pneumonia may suffer from cough, sputum, and chest pain at the same time. There are also special groups such as the elderly who may not even have obvious cough when they have pneumonia, but only fatigue and fever. These symptoms are just for your reference. If the discomfort persists for two or three days without relief, don’t blindly treat yourself with Baidu. It is safest to see a respiratory doctor.