Evaluation and management of exercise-induced dyspnea in otherwise healthy adolescents and young adults: A critical review.

Dyspnea on exertion in otherwise healthy adolescents and young adults is often brought to the attention of a pediatric pulmonologist when it interferes with an athletic activity. Assessment of the cause and management has been controversial. Skilled pediatric pulmonologists may suspect the cause from a careful history, but a more definite diagnosis is needed to provide the most appropriate management. Suspecting that laryngeal obstruction is the major cause, continuous laryngoscopy during exercise has been proposed. However, that method tends to over diagnose laryngeal obstruction and does not consider that the larynx is not the major cause of dyspnea on exertion (DOE). The cause of DOE can generally be best identified by a treadmill test using cardiopulmonary monitoring to determine the physiology associated with reproduced symptoms. Management of DOE requires a specific diagnosis and may involve medication, surgery, or education and training.

Chronic Cough and Causes in Children.

Coughing is a natural means to clear the airway [...].

A Review, Update, and Commentary for the Cough without a Cause: Facts and Factoids of the Habit Cough.

BACKGROUND: A habitual cough, persisting after the cause is gone, was described in a 1694 medical book. Successful treatment of this disorder known as habit cough was reported in 1966 by the "art of suggestion". The purpose of this article is to provide the current basis for diagnosis and treatment of the Habit Cough Syndrome. METHOD: The epidemiology and clinical course of habit cough were reviewed; original data were obtained from three sources. RESULTS: Unique clinical presentation was the basis for diagnosis of habit cough. Diagnosis was made 140 times with increasing frequency over 20 years at the University of Iowa clinic and 55 times over 6 years at a London clinic. Suggestion therapy provided more frequent cessation of cough than just reassurance. A Mayo Clinic archive of chronic involuntary cough found 16 of 60 still coughing 5.9 years after initial evaluation. Ninety-one parents of children with habit cough and 20 adults reported cessation of coughing from viewing a publicly available video of successful suggestion therapy. CONCLUSIONS: Habit cough is recognizable from the clinical presentation. It is effectively treated in most children by suggestion therapy in clinics, by remote video conferencing, and by proxy from viewing a video of effective suggestion therapy.