Metal tone cough

Introduction Can be due to mediastinal tumor, aortic aneurysm (aortic aneurysm) (aorticaneurysm) refers to aortic wall local or diffuse abnormal expansion, compression of surrounding organs caused by symptoms, tumorous rupture is its main risk. Often occurs in the ascending aortic arch , chest descending aorta, thoracic and abdominal aorta and abdominal aorta.) or bronchial cancer and other direct compression of the trachea. There are few positive signs of mediastinal tumors, and the symptoms are related to tumor size, location, growth pattern, texture and nature. Benign tumors grow slowly and can grow to a fairly large, asymptomatic or mild condition.

Cause

It can be caused by direct compression of the trachea such as a mediastinal tumor, aortic aneurysm or bronchial carcinoma. The middle layer of the normal arterial wall is rich in elastic fibers, and the blood is transferred as each heart beats. The middle layer is damaged, the elastic fiber is broken, and the fibrous scar tissue is replaced by the fibrous scar tissue. The arterial wall loses its elasticity and cannot withstand the blood flow impact. The artery gradually expands in the lesion segment to form an aneurysm. An increase in intra-arterial pressure helps to form an aneurysm. The main causes of primary aortic aneurysm are as follows:

Aorta

(a) atherosclerosis: the most common cause. The atheromatous plaque erodes the aortic wall, destroying the middle layer, and the elastic fiber undergoes degeneration. The wall of the tube is thickened by atherosclerosis, which causes the nourishing blood vessels to be compressed, causes nutritional disorders, or nourishes the blood vessels and ruptures in the middle layer. More common in older men, the ratio of men to women is about 10:1. The site is mainly in the abdominal aorta, especially between the origin of the renal artery and the part of the fork.

(B) Infection: Significant syphilis, often eroding the thoracic aorta. Bacteremia in sepsis and endocarditis causes the bacteria to reach the aorta through the bloodstream, and the abscess adjacent to the aorta spreads directly, or secondary infection on the basis of atherosclerotic ulcer can form a bacterial aneurysm. The pathogenic bacteria are mainly streptococcus, staphylococcus and salmonella, which are rare.

(C) cystic middle necrosis: a relatively rare pathological lesion of unknown. The middle aortic elastic fiber is broken and replaced with a metachromatic acid mucopolysaccharide. Mainly seen in ascending aortic aneurysm, more common in men. Hereditary diseases such as Marfan syndrome, Turner syndrome, Ehlers-Danlos syndrome, etc. may have cystic necrosis. Easy to cause a sandwich aneurysm.

(4) Trauma: The penetrating injury directly acts on the aorta in the damaged area to cause an aneurysm, which can occur in any part. Indirect injury often acts on areas that are not easily moved, such as the distal end of the left subclavian artery or the root of the ascending aorta, rather than a moving part, which is more likely to form an aneurysm.

(5) Congenital: mainly aortic sinus tumor.

(6) Others: including giant cell aortitis, Behcet's disease, and more common arteritis.

an examination

Related inspection

Lung imaging lung examination

There are few positive signs of mediastinal tumors, and the symptoms are related to tumor size, location, growth pattern, texture and nature. Benign tumors grow slowly and can grow to a fairly large, asymptomatic or mild condition. Conversely, malignant tumors are highly invasive and progress rapidly, and symptoms can appear at a lower time. Common symptoms include chest pain, chest tightness, cough, edema of the head and face, no sweat on one side, difficulty swallowing, etc. Aortic aneurysm (aortic aneurysm) refers to a local or diffuse abnormal expansion of the aortic wall, which causes symptoms by pressing the surrounding organs, and the tumorous rupture is its main risk. Often occurs in the ascending aorta, aortic arch, thoracic descending aorta, thoracic and abdominal aorta, and abdominal aorta. Common symptoms of tracheal tumor patients are dry cough, shortness of breath, asthma, wheezing, difficulty breathing, cyanosis, physical activity, body position changes, endotracheal secretions can make the symptoms worse, malignant lesions may have hoarseness, difficulty in swallowing.

Differential diagnosis

(1) Cough and hoarseness. It is caused by inflammation of the vocal cords or tumor. Can be seen in laryngitis, laryngeal tuberculosis, laryngeal cancer, etc.

(2) Canine-like cough. Coughing sounds such as canine discomfort are more common in epiglottis, throat disorders or tracheal compression.

(3) The cough is low. The cough sound is low and can be seen in patients with extreme weakness or vocal cord paralysis.

(4) Metal tone cough. It can be caused by direct compression of the trachea such as a mediastinal tumor, aortic aneurysm or bronchial carcinoma.

Cough with symptoms to distinguish diseases:

(1) with fever. Often due to respiratory infections, bronchiectasis complicated by infection, pleurisy and so on.

(2) with chest pain. Common in pneumonia, pleurisy, bronchial cancer, spontaneous pneumothorax.

(3) With weight loss. Those with cough and weight loss should pay attention to tuberculosis and bronchial cancer (primary lung cancer).

(4) With difficulty breathing. Cough with dyspnea is common in severe cardiopulmonary disease, massive pleural effusion, spontaneous pneumothorax.

(5) With a wheezing sound. Cough with wheezing can be seen in bronchial asthma, spastic bronchitis, cardiogenic asthma, and intratracheal foreign body.

(6) With a clubbing finger. The so-called clubbing refers to the obvious widening and thickening of the end knuckles, and the nails are curved from the root to the end. Cough with clubbing can be seen in bronchiectasis, chronic abscess. In short, when coughing occurs, it is not difficult to judge the type and nature of cough as long as it is carefully observed. For severe cough, most people will go to the hospital in time for their impact on life, work and study. For those chronic coughs, especially those that are not severe chronic cough, many patients often do not value it. In fact, the cause of chronic cough is often heavier than the cause of acute severe cough. Especially chronic cough with fever, weight loss should be alert to the risk of tuberculosis, respiratory system primary tumor, should be promptly to the hospital for examination, so early to find the cause, early treatment.

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