Cough syncope
ICD-10 R05.4 is a billable code used to indicate a diagnosis of cough syncope.
Cough syncope refers to a transient loss of consciousness that occurs due to a vigorous cough, often resulting in a brief episode of syncope. This phenomenon is typically associated with a sudden increase in intrathoracic pressure during coughing, which can lead to decreased venous return to the heart and subsequent cerebral hypoperfusion. Patients may present with a history of recurrent cough, often due to underlying respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), or infections. The syncopal episode is usually brief, with patients regaining consciousness quickly after the cough subsides. It is important to differentiate cough syncope from other causes of syncope, as the management may differ based on the underlying etiology. Clinical evaluation may include a thorough history, physical examination, and possibly diagnostic tests such as chest X-rays or pulmonary function tests to identify any underlying respiratory issues.
Detailed history of cough and syncopal episodes, including duration and frequency.
Patients with chronic cough due to asthma or COPD presenting with syncope.
Consideration of comorbidities that may exacerbate cough or syncope.
Acute assessment of the patient’s vital signs and neurological status post-syncope.
Patients presenting to the ER after a syncopal episode triggered by coughing.
Rapid evaluation to rule out other causes of syncope, such as cardiac issues.
Used to assess lung function in patients with chronic cough.
Document indications for spirometry and results.
Internal medicine may focus on chronic management, while emergency medicine may use it for acute assessment.
Cough syncope is primarily caused by increased intrathoracic pressure during a cough, leading to decreased blood flow to the brain.
Cough syncope is characterized by a clear temporal relationship between coughing and loss of consciousness, whereas other types may not have such a direct link.
