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While often annoying, coughing serves an important protective function. This defensive reflex clears the airways of excessive mucus and potentially harmful germs and particles. A short-term cough that accompanies a cold or the flu typically lasts no longer than 3 weeks. A persistent or recurring cough often signals a more serious medical condition. Although coughing usually isn't harmful in and of itself, vigorous attacks can sometimes lead to dangerous complications. These complications occur most often in vulnerable persons, particularly infants and seniors.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Rib Fractures

Broken ribs (rib fractures) represent the most commonly documented complication of cough, as noted in a November 2006 article published in the "World Journal of Emergency Surgery." This complication most often occurs in older adults with a chronic cough and affects women more often than men. Underlying loss of bone mass or osteoporosis increases the risk for cough-induced rib fractures 3. Although rare, broken ribs caused by vigorous coughing can potentially puncture a lung, cause:

  • bleeding within the chest
  • or pierce the diaphragm
  • the muscle that separates the chest
  • abdominal cavities

These rare but dangerous complications of cough-related rib fractures require immediate medical evaluation and treatment.

Fainting

Excessively Coughing? Here's Why

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  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Whooping cough
  • Cystic fibrosis
  • Certain types of heart rhythm abnormalities
  • Gastroesophageal reflux disease (GERD)
  • Brain tumors and excess fluid around the brain (hydrocephalus) :

Abdominal Muscle Tears and Hernias

Vigorous coughing induces extreme, rapidly changing pressure in both the abdominal and chest cavities. This sometimes leads to tears in the abdominal muscles, particularly the paired rectus abdominis muscles that run vertically along either side of the navel. Typical symptoms include sudden pain that worsens with subsequent coughing, sneezing, laughing and lifting. Although rare, coughing might cause a complete rectus tear that allows the intestines to protrude through the abdominal wall -- an abdominal wall hernia. Depending on the size and severity of the hernia, surgical repair might be necessary.

Hypoxia

Signs & Symptoms of Relapse From Pneumonia

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Prolonged, vigorous coughing can potentially interfere with gas exchange in the lungs and lead to reduced oxygen delivery to the body tissues. The brain is particularly susceptible to the damaging effects of oxygen deprivation, also known as hypoxia. Cough-related hypoxia most frequently occurs in babies with whooping cough, also known as pertussis. Compared to older children and adults, babies with pertussis are at increased risk for becoming hypoxic during coughing attacks and might temporarily stop breathing after a coughing episode. Infants with whooping cough are also at increased risk for developing bacterial pneumonia as a complication of the illness, which puts them at further risk for brain hypoxia. Hospitalization with possible temporary placement on a ventilator is sometimes needed for infants with severe whooping cough, particularly if the baby is younger than 6 months.

Other Complications

  • Cough-induced urine leakage
  • Rupture of tiny capillaries in the face or whites of the eyes
  • Nosebleeds
  • Feeding difficulties, gagging or vomiting, particularly in young children
  • Physical exhaustion
  • Headaches 
  • Sleep disruption
  • Social isolation and/or depression :
  • Difficulty breathing, shortness of breath or inability to catch your breath
  • Chest pain, or racing or irregular heartbeat
  • New or worsening abdominal pain or bulge
  • Fever, chills or excessive sweating
    :
The Wrap Up

While often annoying, coughing serves an important protective function. Although coughing usually isn't harmful in and of itself, vigorous attacks can sometimes lead to dangerous complications. This complication most often occurs in older adults with a chronic cough and affects women more often than men. These rare but dangerous complications of cough-related rib fractures require immediate medical evaluation and treatment. This sometimes leads to tears in the abdominal muscles, particularly the paired rectus abdominis muscles that run vertically along either side of the navel. Difficulty breathing, shortness of breath or inability to catch your breath, Chest pain, or racing or irregular heartbeatNew or worsening abdominal pain or bulgeFever, chills or excessive sweating, : .

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