Differential Diagnosis for Cough when Exercising

Single Most Likely Diagnosis

• Asthma: This is the most common cause of cough during exercise, especially in individuals with a history of asthma or atopy. Exercise-induced bronchospasm leads to coughing, wheezing, and shortness of breath.

Other Likely Diagnoses

• Chronic Obstructive Pulmonary Disease (COPD): Patients with COPD may experience a worsening of symptoms, including cough, during exercise due to increased respiratory demand.
• Allergic Rhinitis: Exercise can exacerbate allergic rhinitis symptoms, including cough, in individuals with allergies.
• Gastroesophageal Reflux Disease (GERD): Strenuous exercise can worsen GERD symptoms, leading to cough due to acid reflux.
• Vocal Cord Dysfunction: This condition can cause cough, wheezing, and shortness of breath during exercise due to abnormal vocal cord movement.

Do Not Miss Diagnoses

• Pulmonary Embolism: Although less common, a pulmonary embolism can cause sudden onset of cough and shortness of breath during exercise, which is a medical emergency.
• Cardiac Conditions (e.g., Heart Failure): Exercise-induced cough can be a symptom of underlying cardiac disease, such as heart failure, which requires prompt medical attention.
• Pneumonia or Bronchitis: Infections like pneumonia or bronchitis can cause cough and worsen with exercise, necessitating timely diagnosis and treatment.

Rare Diagnoses

• Cystic Fibrosis: A genetic disorder that can cause chronic cough, among other symptoms, which may worsen with exercise.
• Bronchiectasis: A condition characterized by damaged airways, leading to chronic cough, which can be exacerbated by exercise.
• Exercise-Induced Laryngeal Obstruction (EILO): A rare condition where the larynx partially obstructs during exercise, causing cough, wheezing, and shortness of breath.