Acute cough, which is defined as duration <21 days, is usually related to respiratory infection, aspiration, or inhalation of respiratory irritants. Subacute cough (present for 3–8 weeks) is often related to persistent inflammation from a tracheobronchitis episode. Chronic cough (>8 weeks in duration) can be caused by many pulmonary and cardiac diseases. Chronic bronchitis related to cigarette smoking is a common cause. If the chest radiograph and physical examination are unremarkable, other common causes of chronic cough include cough-variant asthma, gastroesophageal reflux disease (GERD), postnasal drip related to sinus disease, and medications including ACE inhibitors. Irritation of tympanic membranes and chronic eosinophilic bronchitis also can cause chronic cough with a normal chest radiograph. Ineffective cough can predispose to serious respiratory infections due to difficulty clearing lower respiratory secretions; abnormal airway secretions (e.g., due to bronchiectasis) or tracheomalacia can contribute. Weakness or pain limiting abdominal and intercostal muscle use also can lead to ineffective cough.
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