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Original Research: COUGH |

Diagnosis and Management of Premature Ventricular Complexes-Associated Chronic Cough

Sebastian M. Stec, MD; Elżbieta M. Grabczak, MD; Piotr Bielicki, MD; Beata Zaborska, MD; Rafał Krenke, MD; Tomasz Kryński, MD; Marta Dąbrowska, MD; Joanna Domagała-Kulawik, MD; Anna Domeracka-Kołodziej, MD; Agnieszka Sikorska, MD; Piotr Kułakowski, MD; Ryszarda Chazan, MD, FCCP
Author and Funding Information

*From the Department of Cardiology (Drs. Stec, Zaborska, Kryński, Sikorska, and Kułakowski), Grochowski Hospital, Postgraduate Medical School, Warsaw, Poland; and the Departments of Internal Medicine, Pneumonology and Allergology (Drs. Grabczak, Bielicki, Krenke, Dąbrowska, Domagała-Kulawik, and Chazan), and Otolaryngology (Dr. Domeracka-Kołodziej), Warsaw Medical University, Warsaw, Poland.

Correspondence to: Sebastian M. Stec, MD, Postgraduate Medical School, Department of Cardiology, Grochowski Hospital, Grenadierów 51/59, 04-073 Warsaw, Poland; e-mail: smstec@wp.pl


The study was supported in part by Research Grant No. 501-2-1-10-72/04 from the Postgraduate Medical School, Warsaw, Poland.

Dr. Krenke had the fee for his attendance at the 2008 American Thoracic Society Conference paid by Nycomed. Drs. Stec, Grabczak, Bielicki, Zaborska, Kryński, Dąbrowska, Domagała-Kulawik, Domeracka-Kołodziej, Sikorska, Kułakowski, and Chazan have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;135(6):1535-1541. doi:10.1378/chest.08-1814
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Background:  Chronic cough frequently remains 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 (PVCs) in a population of patients with this condition.

Methods:  Patients without organic heart disease who had been referred for the management of symptomatic PVC were evaluated prospectively. PVC-associated cough was recognized if cough episodes occurred just after spontaneous or induced PVC or observed in an ECG or a multichannel recording system that included ECG. A differential diagnosis of cough was performed according to the guidelines on cough. Afterward, antiarrhythmic therapy was instituted to eliminate PVC and cough.

Results:  Of the 120 patients who were referred for the management of PVC, 10 had a chronic cough. After extensive workup for the cause of chronic cough, the cough was thought to be solely due to PVC in one patient, partially due to PVC plus another cause in five patients, and not due to PVC but to nonasthmatic eosinophilic bronchitis, gastroesophageal reflux disease, and chronic sinusitis in four patients. Patients with PVC-associated cough reported more severe perception of symptoms associated with arrhythmia than patients without cough (mean [± SD] visual analog scale score, 8.2 ± 0.5 vs 5.7 ± 1.6, respectively; 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 the proper diagnosis and management of PVC-associated cough.

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