Resolved question:
My mom has hypertension. She started to cough severely for the past week to a point she can't sleep. She discharges mucus (usually light yellow, sometimes darker yellow) through her mouth and nose after a coughing episode. She has already got though flu once this year and it is unusual to get another one two months after the first flu. And, in the past, she had such a cough once and the doctor changed her hypertension meds, which ended the cough. This time, she went to another doctor (internalist) who asked for a chest x-ray. The doctor said the x-ray showed a dark area at the bottom of her left lung (Increased lucency in the area. Not a dark spot) and asked the opinion of another doctor about it. The other doctor wasn't sure what it was and ordered a Thorax CT. The doctor also subscribed antibiotics, cough syrup and changed her hypertension meds and asked my mom to use them for a few days and see if they make a difference. So she will have the Thorax CT done in a few days. My mom was in a car accident about 10 years ago and had a broken rib around the same place where the dark area is on that x-ray, but it has been such a long time, so I don't know if that could have anything to do with it. She recently had some blood work done (which a cardiologist required) and everything looked normal, but her hypertension and sometimes pulse rate was getting out of control even with the meds.
My mom lives in a different country and I am not with her at the moment and worried. I would appreciate your thoughts on the following:
1. Is this a reasonable diagnosis strategy?
2. What could be the reason for the dark area on the x-ray?
Thank you.
Submitted:
4 Days
Category:
Pulmonologist
Hello,
Thank you for choosing DoctorSpring.
1. Yes, this is an excellent diagnostic and treatment approach. The nature of onset and features suggest a possible infective cause. So antibiotics makes sense here. The shadow in the lung filed is something we call a solitary pulmonary nodule. The best and recommended approach in your mothers age group would be a CT Chest.
2. It is very difficult to say what is the lesion without seeing the Xray. It could be a cyst or a gas shadow, a growth. Also there is high possibility that it is an artefact. I would rather wait for the CT result. The previous rib injury if has damaged the lungs at that time might cause this. But it is less likely.
Further confusion can arise if the CT is inconclusive (which happens many a time). Let me know the CT results.
I will keep the consult open.
Hope this helps
Feel free to ask followups
Thank you
Thank you for your input.
My mom has been taking the antibiotics and new hypertension meds for the last three days (this is the third day), but her cough hasn't improved. She says it is usually a dry cough but she is able to get some mucus out (still light yellow) when she forces herself. It has been 12 days this way. She can't sleep because of the cough and is starting to hallucinate even.
She had the CT Chest done yesterday and her doctor today (on the phone) said that the dark area was probably just a piece of "fat," which wasn't something to worry about. My mom will see this doctor again next week for a check.
No other info was given by the doctor today. Could you give me an idea how this piece of fat could get into the lung and would that be causing the cough or could a severe coughing episode cause that to get into the lung? And, so, what is the treatment?
Due to her hypertension (it is a bit more under control now but still goes up and down and the pulse rate goes up to 100s sometimes), I am worried if this could be heart failure. Could it be?
Thank you very much for your help.
Hello,
What your Doctor meant could be that it was an artifact. As in the body fat caused the shadow in the Xray and the CT is normal. Normal fat will not just go into lungs and present like this. To answer your question correctly I will need the CT cuts or at least the report. Please share it with me.
Review your hypertension medication - A class of medication called ACE inhibitors can cause cough.
Heart failure can present like this, but only an ECG and ECHO can tell it for sure. As of now just an ECG will be helpful. If it is normal lets approach the cough first and treat the same. In case if the symptoms persist we can consider a ECHO which will let us know the state of the heart muscles. Let's give the antibiotic some time to work. Meanwhile do share the CT report.
Thank you