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Heavy cough and breathlessness only in the night

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Hi, I need an explanation for a series of symptoms affecting a sibling. He goes through his day with nothing wrong and he is also a very active person. But after he sleeps at night, he occasionally wakes up in the middle of the night with very heavy cough and he finds it hard to breathe. He has been to the hospital and through the tests conducted, it was found that nothing was wrong with his airways or his lungs or any other system in his body. He is currently waiting approval for a brain scan amongst some other tests. Can anyone please explain this condition to me as I am very worried. any help will be deeply appreciated. Thank you.

Category: Cardiologist

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Category: Cardiologist
 27 Doctors Online


Thank you for your query at

Your answers to following would help me best assess your sibling's condition- 1. If the patient has any other illness like diabetes
2. What time of the night Does he have that coughing.
3. Does he have harsh breathing sounds when he has cough
4. Does he have musical wheeze when he has that cough
5. Does the cough disappear on its own - Does he have to open the window and stroll a while to make it disappear?
6. Does it always happen or in particular seasons/environment
7. Does it happen after particular diet or contact with animals
8. Can he run and do exertion without shortness of breath.

Please answer and feel free to discuss further.

Dr Vivek Mahajan

Patient replied :

No he doesn't have any history of diabetes. The cough starts at about 2-3 am. He just finds it hard to breathe. The cough usually lets off when we give him to drink to clear his throat. The cough doesn't happen as a reaction to anything we have noticed so far. It just occurs at night occasionally. He partakes in normal exercises without shortness of breathe. That is what has got us confused because the cough just shows up early at night and doesn't occur again during the day. Initially when it started the doctor we saw said he had upper check infection and he was treated for pneumonia. But that was about a week ago and it let up with the aid of antibiotics only for it to show up again.

Thanks for your reply.

The history seems to be like bronchial asthma. But I would still suggest you to have an echo done to rule out a weak heart or any cardiac disorders.

Seems unlikely given that he exercises normally but still to rule out a cardiac cause of this cough an echo may be helpful.

So once echo is normal you could do a pulmonary function test so as to rule out bronchial asthma or better still if you could take a pulmonologists opinion so that he could rule out any other chest condition which may cause this cough. But before that get an echo done.

Dr Vivek Mahajan
DM Cardiology

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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