Cough Variant Asthma

Cough variant asthma is asthma which has only one symptom: a dry cough which lasts for several weeks.CVA is different to other forms of asthma, which have other additional symptoms such as wheezing, difficulty breathing, and tightness in the chest. You may not find much information about CVA since cough variant asthma is not a common term in the UK, although it is a potential cause of coughs that last longer than 6 to 8 weeks.

A cough caused by CVA lasts for many weeks, is dry, and does not make you produce mucus or phlegm.

Between 30% and 40% of people with a CVA cough will develop other asthma symptoms, according to a review of medical studies from 2011. Therefore treating a CVA cough can reduce the chances of developing more severe asthma symptoms such as difficulty breathing.

There can be some other, potentially serious causes of a cough, so you should contact your doctor urgently if you have a cough that persists for a few weeks. They will ask you questions and examine you to check for the cause of your symptoms.

Can a CVA cough trigger an asthma attack?

An asthma attack occurs when asthma symptoms suddenly get worse and using a reliever inhaler does not help. Symptoms can include wheezing, breathlessness, coughing, or a tight chest. If someone has an asthma attack, their breathing gets faster, and they can get too breathless to speak, eat, or sleep.

There are many triggers for an asthma attack, including allergies, infections, stress, smoke, pollution, changes in weather, exercise and certain medicines.

A CVA cough does not trigger an asthma attack, but it does mean you are more likely to develop other symptoms of asthma and have an asthma attack. This is because a CVA cough can lead to inflamed airways, which can cause other asthma symptoms.

Coughs due to asthma are caused by inflammation of the airways. Once inflamed, the airways become very sensitive and constrict, making it harder to get air in and out. Coughing is the body’s way of trying to clear these airways and get more air into them.

Doctors don’t know precisely why airways become inflamed, but it is known that certain things can start the process. These include:

• allergies such as hay fever, animal fur, and house mites
• pollution and smoke
• cold air
• certain medicines
• exercise
• stress

Asthma coughs are often dry and don’t produce any mucus unless you have a chest infection, in which case you may develop a cough with phlegm.

Why is an asthma cough worse at night?

An asthma cough may be worse when you are trying to sleep at night due to:

• lying down, which can make it harder to circulate air around your lungs and cause any mucus to settle in your chest
• triggers in the bedroom, such as dust mites
• the drop in temperature that usually occurs at night, which can make your airways constrict
• symptoms of heartburn, which can be worse at night and trigger asthma
• airways are at their narrowest at night time in people who suffer with asthma

You cannot diagnose CVA. A doctor will ask about your medical history and perform a medical examination, including listening to how you breathe. They may order a spirometry test that measures how much air you exhale, or a lung x-ray if they are concerned there could be another cause for your cough. It is common for doctors to prescribe patients with asthma inhalers to see if asthma medication helps to clear the cough which can help to confirm the diagnosis of CVA.

CVA can be hard to diagnose because there is just one symptom (a dry cough), and it can take time to confirm that CVA is causing this rather than something else.

CVA is treated in the same way as asthma, primarily with an inhaler which helps you breathe in medicine and improves your symptoms. If your asthma is severe, there are other treatments such as tablets.

The different types of inhalers are:

• reliever inhalers, which stop your symptoms as you experience them
• steroid preventer inhalers, which stop you from getting symptoms in the first place
• combination inhalers, which combine an inhaled steroid with another inhaled preventer to stop symptoms occurring

To treat CVA, a doctor will prescribe you a reliever inhaler, which you can use to stop the cough when it starts. They may wait to see if this helps your symptoms, or they may prescribe you a preventer inhaler immediately.

Your doctor will work with you to create a personal asthma action plan for treating your asthma. They will also talk to you about preventing flare ups by avoiding triggers such as allergens, cigarette smoke, and pollution.

You should go to the doctor about your asthma cough if:

• your symptoms are getting worse
• your symptoms are not going away despite your asthma treatment
• you have to use your inhaler medication more frequently
• your cough is producing thick greenish yellow phlegm or blood, as this could be a sign of an infection or a more serious condition

If you do not already have an asthma diagnosis, talk to your doctor if your cough is persistent and lasts more than 3 weeks. A cough that lasts this long is called a ‘chronic cough’, and can be caused by several factors. These include asthma, smoking, chronic bronchitis, allergies, indigestion, certain medications and less commonly more serious conditions like lung cancer.

Seek urgent medical attention if you are experiencing an asthma attack and your medication is not reducing the symptoms.