Hiccups and fever: The request could not be satisfied

19.11.201921.04.2021 by alexxlab

Содержание

Persistent hiccups an unusual COVID-19 symptom

As the coronavirus pandemic continues to ravage worldwide, new data shows a multitude of symptoms that were not reported previously. It is well-known that the primary symptoms tied to the coronavirus disease are fever, cough, and difficulty of breathing. As time passed by, other symptoms emerged, including the loss of smell and taste, fatigue, body pains, headache, hair loss, and even a rash in the mouth.

Now, a team of researchers revealed another atypical symptom reported by patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes the coronavirus disease (COVID-19) – persistent hiccups.

The case report

Published in the journal The American Journal of Emergency Medicine, a case report by researchers at Cook County Health described an incident wherein a 62-year-old patient who went to the emergency department had reported persistent hiccups for days and an unintentional weight loss over four months.

The man experienced hiccups for four days before being admitted to the hospital due to fever. Further tests revealed the patient had problems with his lung capacity, and he was later isolated and tested COVID-19 infection.

“An abnormal chest X-ray led to a CT scan of the chest with IV contrast, which demonstrated regional, peripheral ground-glass opacities of the upper lobes with small focal ground-glass opacities scattered throughout the lungs,” the authors wrote in the paper.

“He was tested for COVID-19 per admission protocol, started on hydroxychloroquine, his hiccups improved, and he was discharged to home after three days. An emergency medicine physician should keep COVID-19 on the differential and be vigilant of exposure in atypical presentations,” they added.

This is the first case report of persistent hiccups as the presenting complaint in a COVID-19 positive patient, the researchers claimed.

COVID-19 clinical characteristics

The clinical characteristics of COVID-19 are rapidly evolving as data continues to be collected across the globe. As more cases are reported, a multitude of signs and symptoms, even atypical ones, are being reported.

The case report of the man who had hiccups highlights two crucial issues, the researchers noted. First, it underscores the importance of having a detailed evaluation of those presenting with hiccups. Aside from this, it is also important for doctors to take a thorough history, conduct a physical exam, and to obtain general laboratory work and chest X-ray imaging.

Second, doctors and clinicians should keep COVID-19 infection on their differential as more cases are being discovered through atypical symptoms, which could be unexpected and bizarre. Further, doctors and the healthcare team should always maintain personal protective equipment to avoid exposure from patients who do not present with the typical symptoms of the coronavirus infection.

COVID-19 signs and symptoms

The typical signs and symptoms of coronavirus disease include coughing, fever, and shortness of breath, according to the U. S. Centers for Disease Control and Prevention (CDC). As the pandemic evolved throughout the eight months it has rippled across the globe, more signs and symptoms were reported.

These include fatigue, body pain, headache, loss of smell, loss of taste, runny nose or nasal congestion, nausea and vomiting, diarrhea, hair loss, and sore throat. Recently, a new addition has been added, which is the formation of rashes inside the mouth.

In patients with COVID-19, they are to seek medical help if they develop difficulty breathing, persistent pressure or pain in the chest, new confusion, bluish lips or face, and the inability to stay awake. Patients with severe coronavirus illness may develop many complications, including acute respiratory distress syndrome (ARDS), which is life-threatening.

Global situation

The coronavirus pandemic is actively spreading, with the United States reporting the highest number of cases, reaching more than 5 million cases and more than 163,000 deaths. Brazil and India follow with a staggering 3 million and 2 million cases, respectively.

Russia, South Africa, and Mexico report high transmission rates, with cases reaching 890,000, 563,000, and 480,000, respectively. South America has not become the new epicenter of the pandemic, with Brazil, Peru, Colombia, and Chile seeing a surge in infections.

Sources:

Journal reference:

Persistent Hiccups as a Rare Presenting Symptom of Pulmonary Embolism

West J Emerg Med. 2012 Dec; 13(6): 479–483.

Getaw worku Hassen, MD, PhD,Mona Milkha Singh, MD, Hossein Kalantari, MD, Selamawit Yemane-Merriwether, MD, Steven Ferrante, PA, and Ronald Shaw, MD

New York Medical College, Metropolitan Hospital Center, Department of Emergency Medicine, Westchester County, New York

Address for Correspondence: Getaw worku Hassen MD, PhD, New York Medical College, Metropolitan Hospital Center, Department of Emergency Medicine, Westchester County, New York. Email: moc.oohay@hwateg.

Supervising Section Editor: Rick A. McPheeters, DO

Received 2011 Sep 13; Revised 2012 Mar 23; Accepted 2012 Apr 2.

This article has been cited by other articles in PMC.

Abstract

Pulmonary embolism (PE) is a life-threatening condition that may present as dyspnea, chest pain, cough or hemoptysis, but often occurs without symptoms. It is not typically associated with hiccups. Hiccups are generally self-limiting benign contractions of the diaphragm that may be associated with medications or food but may also be symptomatic of serious disease when persistent. We report 3 cases of PE presenting as persistent hiccups.

INTRODUCTION

Pulmonary embolism (PE) is a potentially lethal condition that can be difficult to diagnose. The incidence in the United States is as high as 1 per 1,000 persons per year, and it is the third commonest cause of death in hospitalized patients.¹ Early diagnosis and treatment are crucial in ensuring a good outcome, but symptoms are non-specific and the index of suspicion often low. ²^–⁴ As a result the diagnosis is often made post-mortem.⁵

Hiccup or singultus is the involuntary, spasmodic contraction of the inspiratory muscles, especially the diaphragm. Hiccups are believed to be due to stimulation of the hiccup reflex arc and are generally transient and innocuous. Sometimes they are persistent and symptomatic of organic diseases in the nervous, respiratory, cardiovascular or digestive systems.⁶^–¹²

The hiccup reflex arc consists of an afferent limb that includes the phrenic and vagus nerves, plus sympathetic fibers from T6–10; a center in the brainstem; and an efferent limb consisting mainly of the phrenic nerve. Irritation of any part of the arc in the head, neck, chest or abdomen can lead to hiccups. The irritant may be inflammation, medication, trauma or even over distension of a viscus.⁶^–⁸^,¹²^,¹³

Hiccups have been associated with medications (steroids, dopamine, azithromycin, cefotetan, benzodiazepines, propofol),CNS disorders (tumors and vascular anomalies, multiple sclerosis and seizures), pulmonary disease (lung cancer), gastric and esophageal disease (GERD, herpetic esophagitis, gastric volvulus) and cardiac conditions (myocardial infarction, pacemaker lead injury). ⁷^,⁹^,¹²^,¹⁴^–¹⁷ While many disease entities have been associated with hiccups, we found only one other report of pulmonary embolism presenting as hiccups.²⁸^–³³

Pulmonary embolism may cause irritation of the afferent or efferent limb in the chest, although the exact mechanism that causes hiccups is unclear.

We report here 3 cases of pulmonary embolism presenting as persistent hiccups.

CASE DESCRIPTION

A search of the medical literature (search for PE and intractable hiccups through Medline, the Cochrane library database and Google search engine) did not reveal any case series of hiccups as a presenting symptom of PE, although a single citation describing this entity was identified in the lay literature and one case report.³³^–³⁴ In 2 of our 3 patients, recent surgery was a risk factor for PE.

Patient # 1

A 52-year-old African-American male without significant prior medical or surgical history presented to the emergency department (ED) with a 3-day history of hiccups. He had had progressively worsening dyspnea for 4 weeks, a dry cough and pain in the upper right back associated with inspiration and coughing. He had increasing leg edema for 2 weeks and was told he had congestive heart failure at another institution, where he was advised admission, but left against medical advice. The rest of his review of systems (ROS) was unremarkable and he had no risk factors for deep venous thrombosis (DVT), such as family history of clotting disorder or personal history of immobilization, long journeys, surgery or trauma. He had quit occasional smoking many years ago and did not use alcohol or narcotic drugs.

Physical examination revealed a well-built male in mild respiratory distress with a respiratory rate (RR) of 20 breaths/minute, pulse rate (PR) of 108 beats/minute and blood pressure (BP) 113/76 mmHg. His oxygen saturation was 89–91% on room air. His electrocardiogram (EKG) was normal except for sinus tachycardia, and a duplex ultrasound of his lower extremities was negative for DVT. His portable chest radiograph (CXR) was the first hint of abnormality (), showing a prominent pulmonary central artery (early Fleishner’s sign, red arrow heads) and a pruned tree /cut off of the pulmonary arteries (Westermark’s sign, black arrows). With the working diagnosis of PE, a computed tomography (CT) of the chest with intravenous (IV) contrast was performed which revealed a massive saddle embolus of the pulmonary artery (). Patient was heparinized and transferred to a tertiary center where pulmonary thrombectomy was performed. He made a full recovery with resolution of hiccups and dyspnea. His laboratory examination with complete blood count (CBC), complete metabolic panel (CMP), prothrombin time (PT)/international normalize ration (INR) and partial thromboplastin time (PTT) was essentially normal. Workup for a coagulation disorder failed to reveal a reason for his embolus.

Chest radiograph demonstrating a prominent central pulmonary artery (early Fleishner’s Sign, red arrows) and a cut-off of the pulmonary arteries bilaterally (Westermark sign, black arrows).

A. Computed tomography (CT) showing a saddle embolus (black arrow). B. CT showing a large left pulmonary artery embolus (filling defect, red arrow). C. CT showing a left pulmonary artery embolus (filling defect, red arrows).

Patient # 2

A 40-year-old Hispanic female came for her follow-up gynecology appointment after undergoing total abdominal hysterectomy for fibroids under general anesthesia 12 days earlier. She complained of severe left lower back pain of 1-day duration and was referred to the ED to rule out renal colic. Her postoperative course was uneventful and she had been ambulating on post-operative day #1 and discharged home shortly after surgery. In the ED she spoke in fragmented sentences due to persistent hiccups. ROS and past medical history were unremarkable

Physical examination revealed a young female with hiccups and mild lower abdominal tenderness, but no signs of rhonchi, rales or crepitations in the chest. She was given dilaudid and morphine for back pain, but her PR was 110–120 beats/minute and BP 112/78 mmHg. Temperature was 100.7° Fahrenheit and RR 20 breaths/minute. Based on the previous case of PE presenting with hiccups, a diagnosis of pulmonary embolism was entertained. CXR was unremarkable, but EKG revealed S1T3Q3 changes (). CT chest revealed a large left pulmonary embolus (). Bedside duplex ultrasound did not show DVT. Her laboratory examination with CBC, CMP, PT, INR, and PTT was essentially normal. Workup for a coagulation disorder failed to reveal a reason for his embolus. She was started on IV heparin infusion and warfarin and discharged home with resolution of hiccups and back pain.

An electrocardiogram showing S1Q3T3 pattern indicating the likelihood for the presence of PE.

Patient #3

A 46-year old African-American male presented to the ED with persistent hiccups 2 days after having left inguinal herniorrhaphy under general anesthesia. Surgery was uncomplicated and performed as an ambulatory procedure. He had been ambulating at home, but one day after surgery developed hiccups. His past medical history was unremarkable, but he had undergone right inguinal herniorrhaphy in 2008 without any adverse events or symptoms. He was a nonsmoker and drank no alcohol and denied any other risk factors for DVT.

Physical examination revealed a middle-aged man in no apparent distress except for hiccups. At presentation his temperature was 98° Fahrenheit, PR 81 beats/minute, BP 128/77 mmHg and RR 18 breaths/minute. ECG showed normal sinus rhythm. He was given chlorpromazine, which resolved his hiccups, and he was discharged home. On his way home the hiccups returned and he came back to the ED. A second dose of chlorpromazine failed to resolve the hiccups this time. He also complained of feeling dizzy and his BP was found to be low. A chest CT was ordered and revealed a pulmonary embolus (). His laboratory examination with CBC, CMP, PT, INR, and PTT was essentially normal. Workup for a coagulation disorder failed to reveal a reason for his embolus.

DISCUSSION

The symptoms and signs of PE are highly variable and non-specific and a high index of suspicion is critical in the diagnosis of this potentially lethal condition. The most common symptoms of PE are dyspnea at rest or on exertion (73%), pleuritic chest pain (44%), and cough (34%) with calf pain (44%) and calf or thigh swelling(41%) indicating DVT preceding PE.³⁵^,³⁶ Patients with such symptoms or signs often need additional testing to confirm or exclude the diagnosis. Hiccups on the other hand are rarely associated with PE. Patients may also be completely asymptomatic, making the diagnosis more challenging. A meta-analysis of 28 studies found that among 5,233 patients who had DVT, 1,665 (32%) had asymptomatic PE, highlighting the importance of a high index of suspicion.³⁷ Risk stratification or pretest probability assessment thus becomes paramount in raising awareness of a possible diagnosis of PE.

All patients with chest pain or shortness of breath should have CXR and ECG. In patients with high pretest probability and non-specific symptoms, even if CXR and EKG are normal d-dimer level, lower extremity duplex scan, ventilation-perfusion (VQ) scans and CT angiogram may be needed. ³⁵^,³⁷^–⁴⁰

Numerous prediction models and algorithms have been developed for assessment of patients with possible PE, including the Geneva, Kline, Pulmonary Embolism Rule-out Criteria (PERC), Pisa and Wells systems.⁴¹^–⁴⁶ Of these the Wells criteria and the PERC rules are the most popular. The different elements included in these scoring systems are clinical history, physical examination, and diagnostic tests, such as arterial blood gas, D-dimer, ECG, and CXR with points ascribed to each element. Based on the total score and the clinical picture, the need for additional testing, such as VQ scans and CT angiograms, is determined by the clinician. Thus, by PERC rules if a patient meets all 8 criteria and falls into a low-risk category the probability of PE is < 2% and further testing may not be required. By Wells’ criteria, a patient with low probability of PE and a negative D-dimer test may be discharged home without more testing.

Zylicz reported a case of intractable hiccups due to PE suggesting that a thrombus in the inferior vena cava (shown on ultrasound) caused PE and then hiccups, but no objective evidence of PE is presented.³³ Hiccups resolved with low molecular weight heparin, but recurred when heparin was discontinued. The patient also had underlying non-small cell lung cancer and it is unclear if lung cancer was the source of the hiccups. All of our patients had CT-documented PE and 2 had the risk factor of recent surgery.

Patient # 1 had a low Wells score of 1.5 (HR > 100), making him low risk, but he failed 3 of 8 PERC criteria and the CXR and overall gestalt raised suspicion for PE. Also the Kline decision rule (age/hypoxemia) put him in the unsafe category with a pretest probability of 45.2%. The revised Geneva score placed him in a moderate risk group based on tachycardia alone. Patient # 2 had a score of 3 on Wells criteria (HR > 100; recent surgery) and failed 2 of 8 PERC categories. In patient #3 Wells score was 1.5 (recent surgery), and he failed only 1 of 8 PERC categories.

Different scoring systems put patients in different risk categories highlighting the difficulty in relying only on one scoring system. Intractable hiccups in 2 patients raised our level of suspicion after our experience with patient #1, although both of these patients had recent surgery. CXR in patient #1 and EKG in patient # 2 also helped point us in the right direction. Our series of 3 patients with PE who had hiccups as a presenting symptom highlights the importance of including hiccups in the constellation of symptoms and signs associated with PE. If pretest probability testing is also taken into account, it will help us decide which patients need more advanced imaging and testing to confirm or exclude the diagnosis.

CONCLUSION

Hiccups are common and often idiopathic, but persistent hiccups should be taken seriously. They may be manifestations of immediately life-threatening conditions like myocardial infarction or even pulmonary embolism. Including hiccups in the pantheon of symptoms associated with PE will raise awareness as demonstrated by our small series.

Acknowledgments

The authors would like to thank Drs. Mariadason and Zehtabchi for reviewing and proofreading the manuscript.

Footnotes

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

REFERENCES

2. Kline JA, Hernandez-Nino J, Jones AE, et al. Prospective study of the clinical features and outcomes of emergency department patients with delayed diagnosis of pulmonary embolism. Acad Emerg Med. 2007;14:592–8. [PubMed] [Google Scholar]3. Kline JA, Mitchell AM, Kabrhel C, et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost. 2004;2:1247–55. [PubMed] [Google Scholar]4. Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med. 2006;144:165–71. [PubMed] [Google Scholar]5. Sandler DA, Martin JF. Autopsy proven pulmonary embolism in hospital patients: are we detecting enough deep vein thrombosis? J R Soc Med. 1989;82:203–5. [PMC free article] [PubMed] [Google Scholar]6. Gigot AF, Flynn PD. Treatment of hiccups. J Am Med Assoc. 1952;150:760–4. [PubMed] [Google Scholar]7. Lewis JH. Hiccups: causes and cures. J Clin Gastroenterol. 1985;7:539–52. [PubMed] [Google Scholar]8. Marai I, Levi Y. [The diverse etiology of hiccups] Harefuah. 2003;142:10–3. 79. [PubMed] [Google Scholar]9. Martinez Rey C, Villamil Cajoto I. [Hiccup: review of 24 cases] Rev Med Chil. 2007;135:1132–8. [PubMed] [Google Scholar]10. Nathan MD, Leshner RT, Keller AP., Jr Intractable hiccups. (singultus) Laryngoscope. 1980;90:1612–8. [PubMed] [Google Scholar]12. Souadjian JV, Cain JC. Intractable hiccup. Etiologic factors in 220 cases. Postgrad Med. 1968;43:72–7. [PubMed] [Google Scholar]13. Loft LM, Ward RF. Hiccups. A case presentation and etiologic review. Arch Otolaryngol Head Neck Surg. 1992;118:1115–9. [PubMed] [Google Scholar]14. Errante D, Bernardi D, Bianco A, et al. Recurrence of exhausting hiccup in a patient treated with chemotherapy for metastatic colon cancer. Gut. 2005;54:1503–4. [PMC free article] [PubMed] [Google Scholar]15. Takiguchi Y, Watanabe R, Nagao K, et al. Hiccups as an adverse reaction to cancer chemotherapy. J Natl Cancer Inst. 2002;94:772. [PubMed] [Google Scholar]16. Miyaoka H, Kamijima K. Perphenazine-induced hiccups. Pharmacopsychiatry. 1999;32:81. [PubMed] [Google Scholar]17. Thompson DF, Landry JP. Drug-induced hiccups. Ann Pharmacother. 1997;31:367–9. [PubMed] [Google Scholar]18. Arami MA. A case of brainstem cavernous angioma presenting with persistent hiccups. Acta Med Iran. 48:277–8. [PubMed] [Google Scholar]19. Dickerman RD, Jaikumar S. The hiccup reflex arc and persistent hiccups with high-dose anabolic steroids: is the brainstem the steroid-responsive locus? Clin Neuropharmacol. 2001;24:62–4. [PubMed] [Google Scholar]20. McFarling DA, Susac JO. Hoquet diabolique: intractable hiccups as a manifestation of multiple sclerosis. Neurology. 1979;29:797–801. [PubMed] [Google Scholar]21. Nickerson RB, Atchison JW, Van Hoose JD, et al. Hiccups associated with lateral medullary syndrome. A case report. Am J Phys Med Rehabil. 1997;76:144–6. [PubMed] [Google Scholar]22. de Hoyos A, Esparza EA, Cervantes-Sodi M. Non-erosive reflux disease manifested exclusively by protracted hiccups. J Neurogastroenterol Motil. 16:424–7. [PMC free article] [PubMed] [Google Scholar]23. Hackworth WA, Kimmelshue KN, Stravitz RT. Peritoneal sarcoidosis: a unique cause of ascites and intractable hiccups. Gastroenterol Hepatol (N Y) 2009;5:859–61. [PMC free article] [PubMed] [Google Scholar]24. Haas C, Degoutte E, Biclet P, et al. [Intractable hiccup caused by hiatal hernia with esophagitis] Presse Med. 1989;18:634. [PubMed] [Google Scholar]25. Kounis NG. Persistent hiccuping in acute myocardial infarction–report of a case. Ir Med J. 1974;67:644–5. [PubMed] [Google Scholar]26. Krysiak W, Szabowski S, Stepie M, et al. Hiccups as a myocardial ischemia symptom. Pol Arch Med Wewn. 2008;118:148–51. [PubMed] [Google Scholar]27. Celik T, Kose S, Bugan B, et al. Hiccup as a result of late lead perforation: report of two cases and review of the literature. Europace. 2009;11:963–5. [PubMed] [Google Scholar]28. Cheng MH, Twu NF, Fuh JL, et al. Intractable hiccups as an unusual presentation of a uterine leiomyoma: a case report. J Reprod Med. 2005;50:954–6. [PubMed] [Google Scholar]29. Jones JS, Lloyd T, Cannon L. Persistent hiccups as an unusual manifestation of hyponatremia. J Emerg Med. 1987;5:283–7. [PubMed] [Google Scholar]30. Kumar A, Dromerick AW. Intractable hiccups during stroke rehabilitation. Arch Phys Med Rehabil. 1998;79:697–9. [PubMed] [Google Scholar]31. Marinella MA. Diagnosis and management of hiccups in the patient with advanced cancer. J Support Oncol. 2009;7:122–7. 130. [PubMed] [Google Scholar]32. Payne BR, Tiel RL, Payne MS, et al. Vagus nerve stimulation for chronic intractable hiccups. Case report. J Neurosurg. 2005;102:935–7. [PubMed] [Google Scholar]33. Zylicz Z. Intractable hiccups caused by pulmonary embolism. A case report. Adv. Pall. Med. 2009;4:149–152. [Google Scholar]35. Courtney DM, Kline JA, Kabrhel C, et al. Clinical features from the history and physical examination that predict the presence or absence of pulmonary embolism in symptomatic emergency department patients: results of a prospective, multicenter study. Ann Emerg Med. 55:307–315. [PMC free article] [PubMed] [Google Scholar]36. Kabrhel C, McAfee AT, Goldhaber SZ. The contribution of the subjective component of the Canadian Pulmonary Embolism Score to the overall score in emergency department patients. Acad Emerg Med. 2005;12:915–20. [PubMed] [Google Scholar]37. Stein PD, Woodard PK, Weg JG, et al. Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II Investigators. Radiology. 2007;242:15–21. [PubMed] [Google Scholar]38. Daniel KR, Jackson RE, Kline JA. Utility of lower extremity venous ultrasound scanning in the diagnosis and exclusion of pulmonary embolism in outpatients. Ann Emerg Med. 2000;35:547–54. [PubMed] [Google Scholar]39. Pini M, Marchini L, Giordano A. Diagnostic strategies in venous thromboembolism. Haematologica. 1999;84:535–40. [PubMed] [Google Scholar]40. Stein PD, Hull R, Patel K, et al. D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med. 2004;140:589–602. [PubMed] [Google Scholar]41. Kline JA, Courtney DM, Kabrhel C, et al. Prospective multicenter evaluation of the pulmonary embolism rule-out criteria. J Thromb Haemost. 2008;6:772–80. [PubMed] [Google Scholar]42. Kline JA, Nelson RD, Jackson RE, et al. Criteria for the safe use of D-dimer testing in emergency department patients with suspected pulmonary embolism: a multicenter US study. Ann Emerg Med. 2002;39:144–52. [PubMed] [Google Scholar]43. Klok FA, Mos IC, Nijkeuter M, et al. Simplification of the revised Geneva score for assessing clinical probability of pulmonary embolism. Arch Intern Med. 2008;168:2131–6. [PubMed] [Google Scholar]44. Miniati M, Monti S, Bottai M. A structured clinical model for predicting the probability of pulmonary embolism. Am J Med. 2003;114:173–9. [PubMed] [Google Scholar]45. Wells PS, Anderson DR, Rodger M, et al. Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost. 2000;83:416–20. [PubMed] [Google Scholar]46. Wicki J, Perneger TV, Junod AF, et al. Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med. 2001;161:92–7. [PubMed] [Google Scholar]

Hiccups: Causes, treatment, and complications

Hiccups happen when a person’s intake of air becomes momentarily blocked. It can happen for no apparent reason. It is usually a minor nuisance, but prolonged hiccups can indicate a serious medical problem.

When a hiccup forms, it is because of a sudden, involuntary contraction of the diaphragm at the same time as a contraction of the voice box, or larynx, and a total closure of the glottis. This results in a sudden rush of air into the lungs, and the familiar “hic” sound.

The glottis is the middle part of the larynx, where the vocal cords are located.

Hiccups are medically known as synchronous diaphragmatic flutter or singultus (SDF). They can occur individually or in bouts. They are often rhythmic, meaning that the interval between each hiccup is relatively constant.

Most people have hiccups from time to time, and they usually resolve without treatment within a few minutes.

Rarely, there may be prolonged or chronic hiccups, which can last a month or more. Hiccups that last over 2 months are known as intractable hiccups.

If a bout lasts longer than 48 hours, this is considered persistent, and the person should see a doctor. It could be a sign of a more serious medical condition. This tends to be more common in men than in women.

The longest recorded case of hiccups lasted 60 years.

Fast facts on hiccups

The exact cause of hiccups remains unclear, but chronic hiccups are linked to a wide range of medical conditions, including stroke and gastrointestinal problems.
Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression.
If hiccups last for longer than 48 hours, the person should see a doctor, who may prescribe muscle relaxants.
Avoiding alcohol and not eating too quickly can help reduce the chance of hiccups.

Share on PinterestHiccups can occur after eating spicy food, drinking alcohol, and a range of other situations.

The National Organization for Rare Diseases (NORD) describes hiccups as “an involuntary spasmodic contraction of the muscle at the base of the lungs (diaphragm) followed by the rapid closure of the vocal cords.”

A wide range of underlying conditions can trigger chronic or persistent hiccups.

Exactly how or why short bouts of hiccups happen remains unclear, but some factors have been associated with a higher risk of having them.

Lifestyle factors

The following may trigger hiccups:

hot or spicy food that irritates the phrenic nerve, which is near the esophagus
gas in the stomach that presses against the diaphragm
eating too much or Causing stomach distension
drinking sodas, hot liquids, or alcoholic drinks, especially carbonated drinks
experiencing stress or strong emotions

Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and methyldopa are known to cause hiccups.

Medical conditions

Often, hiccups occur unexpectedly and neither the patient nor the doctor can identify their likely cause.

However, a number of medical conditions have been linked to chronic hiccups.

These include:

gastrointestinal conditions, including inflammatory bowel disease (IBD), a small bowel obstruction, or gastroesophageal reflux disease (GERD)
respiratory conditions, such as pleurisy of the diaphragm, pneumonia, or asthma
excessive and habitual consumption of alcohol
conditions that affect the central nervous system (CNS), including a traumatic brain injury (TNI), encephalitis, a brain tumor, or stroke
conditions that irritate the vagus nerve, such as meningitis, pharyngitis, or goitre
psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock
conditions that affect metabolism, including hyperglycemia, hypoglycemia, or diabetes
liver and kidney problems
cancer, either as a result of damage caused by the condition or as a side effect of treatment, such as chemotherapy.
conditions of the autonomic nervous system, which also affects breathing, sweating, heartbeat, hiccups, and coughing

Other conditions include bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis. Surgery, tumors, and lesions may also be risk factors.

Most cases of hiccups will go away after a few minutes or hours with no medical treatment. If they persist, see your doctor.

Some tips may help, but their effectiveness is uncertain.

Tips for getting rid of hiccups

The following steps may help get rid of hiccups:

Sip ice-cold water slowly or gargle with very cold water.
Hold your breath for a short time, breath out, then do it again three or four times, and do this every 20 minutes.
While you swallow, place gentle pressure on your nose.
Place gentle pressure on your diaphragm.
Bite on a lemon.
Swallow some granulated sugar.
Take a tiny amount of vinegar, just enough to taste.
Breathe in and out of a paper bag, but never a plastic bag and never covering your head with the bag.
Sit down and hug your knees as close to your chest as possible for a short time.
Lean forward so that you gently compress your chest.
Alternative therapies may include acupuncture and hypnosis.
Gently pull on the tongue.
Rub the eyeballs.
Put your finger in your throat to trigger a gag reflex.

Many of these tips have been passed down through generations. They may be effective, but there is little research to support their use.

Medications

If a person has an underlying condition, managing the condition will probably resolve the hiccups.

If prolonged hiccups interfere with a person’s quality of life, the doctor may prescribe a drug.

The following medications may help if there appears to be no underlying health condition:

baclofen (Lioresal), a muscle relaxant
gabapentin, an anti-seizure medication that is commonly prescribed for neuropathic pain, this can help alleviate the symptoms of hiccups

If these do not work, the following are recommended:

chlorpromazine or haloperidol, antipsychotic medications that can alleviate hiccups
metoclopramide (Reglan), an anti-nausea medication, that may help some people with hiccups

Ephedrine or ketamine can treat hiccups related to anesthesia or surgery.

The doctor will usually prescribe a low-dose, two-week course of medication. They may gradually increase the dosage until the hiccups are gone.

The course and dosage will depend on the severity of hiccups, the patients’ general health, and their age.

Surgery

In severe cases that have not responded to other treatment, a surgeon may inject medication into the phrenic nerve to temporarily block the nerve’s action, or sever the phrenic nerve in the neck.

Prolonged hiccups can lead to complications such as:

Weight loss and dehydration: If the hiccups are long-term and occur at short intervals, it can become difficult to eat properly.
Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep or stay asleep.
Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
Communication problems: It can be difficult for the person to speak.
Depression: Long-term hiccups can increase the risk of developing clinical depression.
Delayed wound healing: Persistent hiccups can make it harder for post-surgical wounds to heal, increasing the risk of infections or bleeding after surgery.

Other complications include irregular heart beat and gastro-esophageal reflux (GERD).

Hiccups that last less than 48 hours do not usually need any medical attention, because they resolve on their own.

If they persist for longer, a doctor should be consulted.

The doctor may ask when the hiccups began, how often they occur, how frequent they are, whether they are happening all the time, and what a person was doing before they started.

They will probably perform a general physical examination and a neurological exam to check the person’s:

reflexes
balance
coordination
eyesight
sense of touch
muscle strength
muscle tone

If an underlying condition may be the cause, the following tests may be ordered:

blood tests, to check for infection, kidney disease or diabetes
imaging tests, such as an x-ray, CT, or MRI scan, to assess for any anatomical abnormalities which may be affecting the phrenic or vagus nerves or the diaphragm
endoscopic test, in which an endoscope, a flexible tube with a small camera at the end, is passed down the patient’s throat to check the windpipe or esophagus
en electrocardiogram (ECG), to check for heart-related conditions by measuring electrical activity in the heart

Some causes of hiccups are preventable.

Ways of reducing the risk include:

avoiding sudden changes in temperature
not drinking alcohol or sodas
eating moderately and not too quickly

Most hiccups are brief and go away after a short while, but if they persist, or if you are concerned about other symptoms, you should see a doctor.

Hiccups: Causes, treatment, and complications

The glottis is the middle part of the larynx, where the vocal cords are located.

Most people have hiccups from time to time, and they usually resolve without treatment within a few minutes.

Rarely, there may be prolonged or chronic hiccups, which can last a month or more. Hiccups that last over 2 months are known as intractable hiccups.

The longest recorded case of hiccups lasted 60 years.

Fast facts on hiccups

The exact cause of hiccups remains unclear, but chronic hiccups are linked to a wide range of medical conditions, including stroke and gastrointestinal problems.
Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression.
If hiccups last for longer than 48 hours, the person should see a doctor, who may prescribe muscle relaxants.
Avoiding alcohol and not eating too quickly can help reduce the chance of hiccups.

Share on PinterestHiccups can occur after eating spicy food, drinking alcohol, and a range of other situations.

A wide range of underlying conditions can trigger chronic or persistent hiccups.

Exactly how or why short bouts of hiccups happen remains unclear, but some factors have been associated with a higher risk of having them.

Lifestyle factors

The following may trigger hiccups:

hot or spicy food that irritates the phrenic nerve, which is near the esophagus
gas in the stomach that presses against the diaphragm
eating too much or Causing stomach distension
drinking sodas, hot liquids, or alcoholic drinks, especially carbonated drinks
experiencing stress or strong emotions

Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and methyldopa are known to cause hiccups.

Medical conditions

Often, hiccups occur unexpectedly and neither the patient nor the doctor can identify their likely cause.

However, a number of medical conditions have been linked to chronic hiccups.

These include:

gastrointestinal conditions, including inflammatory bowel disease (IBD), a small bowel obstruction, or gastroesophageal reflux disease (GERD)
respiratory conditions, such as pleurisy of the diaphragm, pneumonia, or asthma
excessive and habitual consumption of alcohol
conditions that affect the central nervous system (CNS), including a traumatic brain injury (TNI), encephalitis, a brain tumor, or stroke
conditions that irritate the vagus nerve, such as meningitis, pharyngitis, or goitre
psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock
conditions that affect metabolism, including hyperglycemia, hypoglycemia, or diabetes
liver and kidney problems
cancer, either as a result of damage caused by the condition or as a side effect of treatment, such as chemotherapy.
conditions of the autonomic nervous system, which also affects breathing, sweating, heartbeat, hiccups, and coughing

Other conditions include bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis. Surgery, tumors, and lesions may also be risk factors.

Most cases of hiccups will go away after a few minutes or hours with no medical treatment. If they persist, see your doctor.

Some tips may help, but their effectiveness is uncertain.

Tips for getting rid of hiccups

The following steps may help get rid of hiccups:

Sip ice-cold water slowly or gargle with very cold water.
Hold your breath for a short time, breath out, then do it again three or four times, and do this every 20 minutes.
While you swallow, place gentle pressure on your nose.
Place gentle pressure on your diaphragm.
Bite on a lemon.
Swallow some granulated sugar.
Take a tiny amount of vinegar, just enough to taste.
Breathe in and out of a paper bag, but never a plastic bag and never covering your head with the bag.
Sit down and hug your knees as close to your chest as possible for a short time.
Lean forward so that you gently compress your chest.
Alternative therapies may include acupuncture and hypnosis.
Gently pull on the tongue.
Rub the eyeballs.
Put your finger in your throat to trigger a gag reflex.

Many of these tips have been passed down through generations. They may be effective, but there is little research to support their use.

Medications

If a person has an underlying condition, managing the condition will probably resolve the hiccups.

If prolonged hiccups interfere with a person’s quality of life, the doctor may prescribe a drug.

The following medications may help if there appears to be no underlying health condition:

baclofen (Lioresal), a muscle relaxant
gabapentin, an anti-seizure medication that is commonly prescribed for neuropathic pain, this can help alleviate the symptoms of hiccups

If these do not work, the following are recommended:

chlorpromazine or haloperidol, antipsychotic medications that can alleviate hiccups
metoclopramide (Reglan), an anti-nausea medication, that may help some people with hiccups

Ephedrine or ketamine can treat hiccups related to anesthesia or surgery.

The doctor will usually prescribe a low-dose, two-week course of medication. They may gradually increase the dosage until the hiccups are gone.

The course and dosage will depend on the severity of hiccups, the patients’ general health, and their age.

Surgery

In severe cases that have not responded to other treatment, a surgeon may inject medication into the phrenic nerve to temporarily block the nerve’s action, or sever the phrenic nerve in the neck.

Prolonged hiccups can lead to complications such as:

Weight loss and dehydration: If the hiccups are long-term and occur at short intervals, it can become difficult to eat properly.
Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep or stay asleep.
Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
Communication problems: It can be difficult for the person to speak.
Depression: Long-term hiccups can increase the risk of developing clinical depression.
Delayed wound healing: Persistent hiccups can make it harder for post-surgical wounds to heal, increasing the risk of infections or bleeding after surgery.

Other complications include irregular heart beat and gastro-esophageal reflux (GERD).

Hiccups that last less than 48 hours do not usually need any medical attention, because they resolve on their own.

If they persist for longer, a doctor should be consulted.

The doctor may ask when the hiccups began, how often they occur, how frequent they are, whether they are happening all the time, and what a person was doing before they started.

They will probably perform a general physical examination and a neurological exam to check the person’s:

reflexes
balance
coordination
eyesight
sense of touch
muscle strength
muscle tone

If an underlying condition may be the cause, the following tests may be ordered:

blood tests, to check for infection, kidney disease or diabetes
imaging tests, such as an x-ray, CT, or MRI scan, to assess for any anatomical abnormalities which may be affecting the phrenic or vagus nerves or the diaphragm
endoscopic test, in which an endoscope, a flexible tube with a small camera at the end, is passed down the patient’s throat to check the windpipe or esophagus
en electrocardiogram (ECG), to check for heart-related conditions by measuring electrical activity in the heart

Some causes of hiccups are preventable.

Ways of reducing the risk include:

avoiding sudden changes in temperature
not drinking alcohol or sodas
eating moderately and not too quickly

Most hiccups are brief and go away after a short while, but if they persist, or if you are concerned about other symptoms, you should see a doctor.

Hiccups: Causes, treatment, and complications

The glottis is the middle part of the larynx, where the vocal cords are located.

Most people have hiccups from time to time, and they usually resolve without treatment within a few minutes.

Rarely, there may be prolonged or chronic hiccups, which can last a month or more. Hiccups that last over 2 months are known as intractable hiccups.

The longest recorded case of hiccups lasted 60 years.

Fast facts on hiccups

The exact cause of hiccups remains unclear, but chronic hiccups are linked to a wide range of medical conditions, including stroke and gastrointestinal problems.
Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression.
If hiccups last for longer than 48 hours, the person should see a doctor, who may prescribe muscle relaxants.
Avoiding alcohol and not eating too quickly can help reduce the chance of hiccups.

Share on PinterestHiccups can occur after eating spicy food, drinking alcohol, and a range of other situations.

A wide range of underlying conditions can trigger chronic or persistent hiccups.

Exactly how or why short bouts of hiccups happen remains unclear, but some factors have been associated with a higher risk of having them.

Lifestyle factors

The following may trigger hiccups:

hot or spicy food that irritates the phrenic nerve, which is near the esophagus
gas in the stomach that presses against the diaphragm
eating too much or Causing stomach distension
drinking sodas, hot liquids, or alcoholic drinks, especially carbonated drinks
experiencing stress or strong emotions

Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and methyldopa are known to cause hiccups.

Medical conditions

Often, hiccups occur unexpectedly and neither the patient nor the doctor can identify their likely cause.

However, a number of medical conditions have been linked to chronic hiccups.

These include:

gastrointestinal conditions, including inflammatory bowel disease (IBD), a small bowel obstruction, or gastroesophageal reflux disease (GERD)
respiratory conditions, such as pleurisy of the diaphragm, pneumonia, or asthma
excessive and habitual consumption of alcohol
conditions that affect the central nervous system (CNS), including a traumatic brain injury (TNI), encephalitis, a brain tumor, or stroke
conditions that irritate the vagus nerve, such as meningitis, pharyngitis, or goitre
psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock
conditions that affect metabolism, including hyperglycemia, hypoglycemia, or diabetes
liver and kidney problems
cancer, either as a result of damage caused by the condition or as a side effect of treatment, such as chemotherapy.
conditions of the autonomic nervous system, which also affects breathing, sweating, heartbeat, hiccups, and coughing

Other conditions include bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis. Surgery, tumors, and lesions may also be risk factors.

Most cases of hiccups will go away after a few minutes or hours with no medical treatment. If they persist, see your doctor.

Some tips may help, but their effectiveness is uncertain.

Tips for getting rid of hiccups

The following steps may help get rid of hiccups:

Sip ice-cold water slowly or gargle with very cold water.
Hold your breath for a short time, breath out, then do it again three or four times, and do this every 20 minutes.
While you swallow, place gentle pressure on your nose.
Place gentle pressure on your diaphragm.
Bite on a lemon.
Swallow some granulated sugar.
Take a tiny amount of vinegar, just enough to taste.
Breathe in and out of a paper bag, but never a plastic bag and never covering your head with the bag.
Sit down and hug your knees as close to your chest as possible for a short time.
Lean forward so that you gently compress your chest.
Alternative therapies may include acupuncture and hypnosis.
Gently pull on the tongue.
Rub the eyeballs.
Put your finger in your throat to trigger a gag reflex.

Many of these tips have been passed down through generations. They may be effective, but there is little research to support their use.

Medications

If a person has an underlying condition, managing the condition will probably resolve the hiccups.

If prolonged hiccups interfere with a person’s quality of life, the doctor may prescribe a drug.

The following medications may help if there appears to be no underlying health condition:

baclofen (Lioresal), a muscle relaxant
gabapentin, an anti-seizure medication that is commonly prescribed for neuropathic pain, this can help alleviate the symptoms of hiccups

If these do not work, the following are recommended:

chlorpromazine or haloperidol, antipsychotic medications that can alleviate hiccups
metoclopramide (Reglan), an anti-nausea medication, that may help some people with hiccups

Ephedrine or ketamine can treat hiccups related to anesthesia or surgery.

The doctor will usually prescribe a low-dose, two-week course of medication. They may gradually increase the dosage until the hiccups are gone.

The course and dosage will depend on the severity of hiccups, the patients’ general health, and their age.

Surgery

In severe cases that have not responded to other treatment, a surgeon may inject medication into the phrenic nerve to temporarily block the nerve’s action, or sever the phrenic nerve in the neck.

Prolonged hiccups can lead to complications such as:

Weight loss and dehydration: If the hiccups are long-term and occur at short intervals, it can become difficult to eat properly.
Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep or stay asleep.
Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
Communication problems: It can be difficult for the person to speak.
Depression: Long-term hiccups can increase the risk of developing clinical depression.
Delayed wound healing: Persistent hiccups can make it harder for post-surgical wounds to heal, increasing the risk of infections or bleeding after surgery.

Other complications include irregular heart beat and gastro-esophageal reflux (GERD).

Hiccups that last less than 48 hours do not usually need any medical attention, because they resolve on their own.

If they persist for longer, a doctor should be consulted.

The doctor may ask when the hiccups began, how often they occur, how frequent they are, whether they are happening all the time, and what a person was doing before they started.

They will probably perform a general physical examination and a neurological exam to check the person’s:

reflexes
balance
coordination
eyesight
sense of touch
muscle strength
muscle tone

If an underlying condition may be the cause, the following tests may be ordered:

blood tests, to check for infection, kidney disease or diabetes
imaging tests, such as an x-ray, CT, or MRI scan, to assess for any anatomical abnormalities which may be affecting the phrenic or vagus nerves or the diaphragm
endoscopic test, in which an endoscope, a flexible tube with a small camera at the end, is passed down the patient’s throat to check the windpipe or esophagus
en electrocardiogram (ECG), to check for heart-related conditions by measuring electrical activity in the heart

Some causes of hiccups are preventable.

Ways of reducing the risk include:

avoiding sudden changes in temperature
not drinking alcohol or sodas
eating moderately and not too quickly

Most hiccups are brief and go away after a short while, but if they persist, or if you are concerned about other symptoms, you should see a doctor.

Hiccups: Causes, treatment, and complications

The glottis is the middle part of the larynx, where the vocal cords are located.

Most people have hiccups from time to time, and they usually resolve without treatment within a few minutes.

Rarely, there may be prolonged or chronic hiccups, which can last a month or more. Hiccups that last over 2 months are known as intractable hiccups.

The longest recorded case of hiccups lasted 60 years.

Fast facts on hiccups

The exact cause of hiccups remains unclear, but chronic hiccups are linked to a wide range of medical conditions, including stroke and gastrointestinal problems.
Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression.
If hiccups last for longer than 48 hours, the person should see a doctor, who may prescribe muscle relaxants.
Avoiding alcohol and not eating too quickly can help reduce the chance of hiccups.

Share on PinterestHiccups can occur after eating spicy food, drinking alcohol, and a range of other situations.

A wide range of underlying conditions can trigger chronic or persistent hiccups.

Exactly how or why short bouts of hiccups happen remains unclear, but some factors have been associated with a higher risk of having them.

Lifestyle factors

The following may trigger hiccups:

hot or spicy food that irritates the phrenic nerve, which is near the esophagus
gas in the stomach that presses against the diaphragm
eating too much or Causing stomach distension
drinking sodas, hot liquids, or alcoholic drinks, especially carbonated drinks
experiencing stress or strong emotions

Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and methyldopa are known to cause hiccups.

Medical conditions

Often, hiccups occur unexpectedly and neither the patient nor the doctor can identify their likely cause.

However, a number of medical conditions have been linked to chronic hiccups.

These include:

gastrointestinal conditions, including inflammatory bowel disease (IBD), a small bowel obstruction, or gastroesophageal reflux disease (GERD)
respiratory conditions, such as pleurisy of the diaphragm, pneumonia, or asthma
excessive and habitual consumption of alcohol
conditions that affect the central nervous system (CNS), including a traumatic brain injury (TNI), encephalitis, a brain tumor, or stroke
conditions that irritate the vagus nerve, such as meningitis, pharyngitis, or goitre
psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock
conditions that affect metabolism, including hyperglycemia, hypoglycemia, or diabetes
liver and kidney problems
cancer, either as a result of damage caused by the condition or as a side effect of treatment, such as chemotherapy.
conditions of the autonomic nervous system, which also affects breathing, sweating, heartbeat, hiccups, and coughing

Other conditions include bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis. Surgery, tumors, and lesions may also be risk factors.

Most cases of hiccups will go away after a few minutes or hours with no medical treatment. If they persist, see your doctor.

Some tips may help, but their effectiveness is uncertain.

Tips for getting rid of hiccups

The following steps may help get rid of hiccups:

Sip ice-cold water slowly or gargle with very cold water.
Hold your breath for a short time, breath out, then do it again three or four times, and do this every 20 minutes.
While you swallow, place gentle pressure on your nose.
Place gentle pressure on your diaphragm.
Bite on a lemon.
Swallow some granulated sugar.
Take a tiny amount of vinegar, just enough to taste.
Breathe in and out of a paper bag, but never a plastic bag and never covering your head with the bag.
Sit down and hug your knees as close to your chest as possible for a short time.
Lean forward so that you gently compress your chest.
Alternative therapies may include acupuncture and hypnosis.
Gently pull on the tongue.
Rub the eyeballs.
Put your finger in your throat to trigger a gag reflex.

Many of these tips have been passed down through generations. They may be effective, but there is little research to support their use.

Medications

If a person has an underlying condition, managing the condition will probably resolve the hiccups.

If prolonged hiccups interfere with a person’s quality of life, the doctor may prescribe a drug.

The following medications may help if there appears to be no underlying health condition:

baclofen (Lioresal), a muscle relaxant
gabapentin, an anti-seizure medication that is commonly prescribed for neuropathic pain, this can help alleviate the symptoms of hiccups

If these do not work, the following are recommended:

chlorpromazine or haloperidol, antipsychotic medications that can alleviate hiccups
metoclopramide (Reglan), an anti-nausea medication, that may help some people with hiccups

Ephedrine or ketamine can treat hiccups related to anesthesia or surgery.

The doctor will usually prescribe a low-dose, two-week course of medication. They may gradually increase the dosage until the hiccups are gone.

The course and dosage will depend on the severity of hiccups, the patients’ general health, and their age.

Surgery

In severe cases that have not responded to other treatment, a surgeon may inject medication into the phrenic nerve to temporarily block the nerve’s action, or sever the phrenic nerve in the neck.

Prolonged hiccups can lead to complications such as:

Weight loss and dehydration: If the hiccups are long-term and occur at short intervals, it can become difficult to eat properly.
Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep or stay asleep.
Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
Communication problems: It can be difficult for the person to speak.
Depression: Long-term hiccups can increase the risk of developing clinical depression.
Delayed wound healing: Persistent hiccups can make it harder for post-surgical wounds to heal, increasing the risk of infections or bleeding after surgery.

Other complications include irregular heart beat and gastro-esophageal reflux (GERD).

Hiccups that last less than 48 hours do not usually need any medical attention, because they resolve on their own.

If they persist for longer, a doctor should be consulted.

The doctor may ask when the hiccups began, how often they occur, how frequent they are, whether they are happening all the time, and what a person was doing before they started.

They will probably perform a general physical examination and a neurological exam to check the person’s:

reflexes
balance
coordination
eyesight
sense of touch
muscle strength
muscle tone

If an underlying condition may be the cause, the following tests may be ordered:

blood tests, to check for infection, kidney disease or diabetes
imaging tests, such as an x-ray, CT, or MRI scan, to assess for any anatomical abnormalities which may be affecting the phrenic or vagus nerves or the diaphragm
endoscopic test, in which an endoscope, a flexible tube with a small camera at the end, is passed down the patient’s throat to check the windpipe or esophagus
en electrocardiogram (ECG), to check for heart-related conditions by measuring electrical activity in the heart

Some causes of hiccups are preventable.

Ways of reducing the risk include:

avoiding sudden changes in temperature
not drinking alcohol or sodas
eating moderately and not too quickly

Most hiccups are brief and go away after a short while, but if they persist, or if you are concerned about other symptoms, you should see a doctor.

Are Hiccups A Sign Of Covid-19 Coronavirus? Here Is What Happened In This Case

Can persistent hiccups be a sign of a Covid-19 coronavirus infection? (Photo: Getty)

getty

Think you can rely on just symptoms to diagnose a Covid-19 coronavrius infection? Well, here’s yet another hiccup in that plan. Or rather a bunch of hiccups. A case report recently published in the American Journal of Emergency Medicine suggests that persistent hiccups, otherwise known as hiccoughs, could actually be a symptom of Covid-19.

In the case report, Garrett Prince, MD, and Michelle Sergel, MD, from Cook County Health described what happened to a 62-year-old male, who went to the Cook County Health Emergency Department (ED) after experiencing four days of persistent hiccups and an unintentional 25-pound weight loss over a four month period. The case report described these symptoms in an interesting way, saying that the patient, “endorsed a twenty-five-pound unintentional weight loss over the last four months, and more recently, persistent hiccups for four days prompting his visit to the ED.” By the way, endorsing a hiccup is probably not quite the same as endorsing a check or a political candidate.

Nonetheless, these seemed to be the man’s only symptoms. There was no fever, nasal congestion, sore throat, chest pain, or shortness of breath. There were none of the symptoms found on the Centers for Disease Control and Prevention (CDC) “Symptoms of Coronavirus” list. His only other medical problems seemed to be diabetes, hypertension, and coronary artery disease. A physical exam didn’t reveal much either. His body temperature was 37.3 °C, which is about 99.1 °F. That ain’t really a fever.

But the doctors weren’t ready to send the man home. After all, hiccups are like the Baby Shark Song. Hiccups for a few minutes may be OK and even entertaining to others. However, hiccups for four days is something completely different. In fact, once a bout of hiccups has reached the two day- or 48 hour-mark, it’s time to seek medical attention. Don’t keep trying to scare yourself, breath into a paper bag, or hold your breath. Holding your breath for two straight days may actually take care of your hiccups but not in the way that you’d like. You kind of need oxygen to stay conscious and alive. Of course, if the hiccups are so bad that they are impairing your ability to eat, breathe, or sleep, don’t say, “OK, I can’t breathe but will wait for the two-day mark.” Call your doctor as soon as possible.

Your lungs rest on your diaphragm. When you diaphragm contracts and sinks lower, your lungs expand. … [+] (Image: Getty)

getty

Hiccups are basically spasms of your diaphragm. No, this doesn’t mean that your birth control device is jumping out of its case. Instead, in this case, diaphragm refers to the muscles that sit below your lungs and normally help you inhale when these muscles contract. Contracting these muscles lowers the diaphragm, which then allows your lungs to expand and fill with air. These muscles contract when your phrenic nerve, which runs from your neck to the diaphragm, is activated.

Irritating this nerve may then cause involuntary contractions of your diaphragm and the “hic-hic-hic” in hiccups. An extended bout of hiccups may be a sign that something is continuing to irritate or even damage your phrenic nerve. This could be, for example, a mass somewhere along the phrenic nerve or a nervous system disorder.

Well, that was a word from your sponsors: diaphragms. Back to the case report.

Since the hiccups had persisted for well over two days, the doctors ordered a chest X-ray to check for the presence of a mass or some other abnormality. It’s a good thing that they looked because both of his lungs had “ground glass opacities.” These are hazy appearing areas that look like glass that has been ground. These are not normal findings. Ground glass doesn’t belong in your underwear or on your chest X-ray. On chest imaging, they tend to represent some type of lung inflammation, bleeding, or damage.

A CT scan of his chest confirmed the chest X-ray findings. So perhaps the inflammation in the lungs had triggered the hiccups. Blood tests showed that his white blood cell count, platelet count, sodium levels, and chloride levels were all low. Since something called the Covid-19 coronavirus pandemic is going on right now (just in case you didn’t know), the doctors decided to test him for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) as well and admitted him to the Covid-19 medical unit in the meantime as a precaution.

By the time he had reached the medical unit, his temperature had crept up to 38.4 °C (101.1 °F). In the words of Paris Hilton, that’s hot, and considered a fever. His heart rate had increased too, up to 104 beats per minute. The next day his SARS-CoV2 test came back positive, but not positive in a good, optimistic way. The man had Covid-19. During his stay he received cetriaxone, azithromycin, and hydroxychloroquine. Eventually after three days in the hospital, he was able to leave the hospital in stable condition.

Of note, the case report didn’t say why the man had lost weight. Since it had occurred over a four month period, the Covid-19 coronavirus probably wan’t the culprit.

Now, all of this doesn’t mean that you should freak out the next time that you have hiccups, especially if those hiccups resolve fairly quickly. Remember that many things can trigger hiccups including drinking carbonated beverages or getting excited such as when you see One Direction or when you drink carbonated beverages while seeing One Direction or even better when you and One Direction drink carbonated beverages together. It remains to be seen how rare versus common hiccups may be as Covid-19 symptoms. Remember, something typically becomes a medical case report only when it still is considered to be rare. That’s why you probably won’t see a medical journal case report entitled, “Man Farts, It Smells, End of Story,” anytime soon. Plus a single case report is enough to show that Covid-19 can cause hiccups. It could still have been a coincidence.

Nevertheless, the list of possible Covid-19 symptoms appears to be getting longer and longer. It can seem quite confusing when you are told that Covid-19 can lead to such-and-such symptoms, except when it doesn’t. Or if you have such-and-such symptoms, you may have Covid-19 or you may not. And should such-and-such symptoms appear, you absolutely certainly maybe possibly potentially could have Covid-19, as long as these symptoms aren’t being caused by something else. Well, this virus is still very new and researchers are still learning about what it can do.

All of this is further evidence that relying simply on symptoms to diagnose a Covid-19 coronavirus infection can be like relying on Tinder profiles to determine anything. Sure, diarrhea and vomiting can be bad signs when they are present in either situation. But in either case, just because everything looks OK doesn’t mean that everything is hunky-dory. The only real way to check whether someone is infected with the Covid-19 coronavirus is via testing such as sticking a cotton up his or her nose.

Science: Science and technology: Lenta.ru

Persistent hiccups can be one of the symptoms of coronavirus. This is stated in a report published in The American Journal of Emergency Medicine, writes The Sun.

Doctors described the course of the disease in a 62-year-old patient from Chicago suffering from diabetes mellitus, hypertension and coronary heart disease. In April, he consulted doctors for four days of hiccups. At the same time, he did not have the main symptoms of coronavirus, such as cough, fever, nasal congestion, sore throat or chest, and shortness of breath.

According to the results of the examination, the patient had an elevated temperature – 37.3 degrees, and the test for COVID-19 showed a positive result. On a chest x-ray, the man found slight darkening in the lungs. After that, he was sent to the coronavirus department, where his condition worsened.

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00:01 – April 4, 2020

An American was treated with the antimalarial drug hydroxychloroquine, which was considered a popular coronavirus drug.Subsequently, the WHO recognized it as ineffective for the treatment of COVID-19. Three days later, the man was discharged from the hospital in a stable condition.

“To our knowledge, this is the first report of persistent hiccups as a complaint from a patient who tested positive for COVID-19 in the emergency medicine literature,” the publication said. Doctors urged colleagues to pay close attention to other patients who complain of persistent hiccups, and noted that the coronavirus infection is showing more and more atypical symptoms.

In July, doctors described a case of priapism, a prolonged and painful erection unrelated to sexual arousal. This symptom manifested itself in an elderly Frenchman due to thrombosis due to coronavirus.

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90,000 American doctors have found a new sign of covid-19 / HB

August 16, 2020, 14:08

Tsey material is also available in Ukrainian

Covid-19 – doctors talk about a new symptom (Photo: 9nong / Depositphotos)

A group of American doctors declares about another atypical symptom of Covid-19.

Garrett Prince and Michelle Segel from Cook Hospital in Chicago claim that constant hiccups can be one of the symptoms of coronavirus.

The results of the study are published in The American Journal of Emergency Medicine.

Doctors are considering cases when hiccups, which were not initially paid attention to, turns out to be a symptom of Covid-19.

For example, in April, a man came to a Chicago hospital for several days with hiccups.

There were no suspicions of coronavirus, as well as no symptoms that are considered typical for Covid-19. For example, fever, sore throat, and nasal congestion.

However, the tests made it possible to diagnose the coronavirus, and the X-ray showed serious damage to the lungs.

This patient was safely cured of Covid-19, and doctors received a new direction for research – constant hiccups as a symptom of the coronavirus.

At the moment, doctors believe that constant hiccups in Covid-19 can be caused by damage to the nerve, which is located near the diaphragm of the respiratory tract.It is she who most often causes hiccups.

At the same time, it is possible that the patients themselves and their doctors do not associate hiccups with coronavirus.

The list of coronavirus symptoms is constantly growing.

For example, recently, experts from the US Centers for Disease Control and Prevention added nausea and diarrhea to the list of potential COVID-19 symptoms. They, like most other symptoms, can appear 2-14 days after infection.

Since the start of the pandemic, the most common symptoms of coronavirus have been fever, cough, shortness of breath, fatigue, headache, loss of taste and sore throat.

Acute and chronic esophagitis

The most common cause of is gastroesophageal reflux, leading to damage to the esophageal mucosa due to acid-peptic factors. In case the esophagitis is caused by reflux, it is called reflux esophagitis.

Other causes of esophagitis include:

Infections (most common fungi of the genus Candida, herpes simplex virus, cytomegalovirus). These infections are most common in patients with lowered immunity, in particular, in those suffering from AIDS or receiving immunosuppressive therapy, glucocorticoids, anticancer chemotherapy.
Chemical burns with alkali or acid, solvent (eg gasoline, acetone), strong oxidizing agents such as potassium permanganate can also cause esophagitis. Such esophagitis usually occurs in children after accidental testing or in adults after attempted suicide using an alkali, acid, solvent, or oxidizer; also possible with vomiting and heartburn due to the irritating action of digestive enzymes. It is often observed in alcoholics – in this case, ethyl alcohol is the damaging factor.
Physical damage to the esophagus from radiation therapy or tube insertion can also cause esophagitis.

Acute esophagitis – inflammation of the esophageal wall, manifested by pain, especially pronounced when passing food. In the overwhelming majority of cases, it occurs in combination with stomach diseases and usually affects the lower part of the esophagus.

The onset of the disease is facilitated by malnutrition, burns, chemicals, polyhypovitaminosis, and extensive infection.
With esophagitis, the body temperature may rise, general malaise is noted, unpleasant sensations appear along the esophagus during the movement of food, burning sensation, sometimes sharp pain in the esophagus may disturb. Patients may complain of pain in the neck, belching, drooling, and swallowing is impaired.

Chronic esophagitis – inflammation of the esophageal mucosa, lasting more than 6 months. The disease can develop with insufficiently cured acute esophagitis or as a primary chronic process.Chronic esophagitis can develop with prolonged intake of excessively rough or spicy food, strong alcoholic beverages.

The most common variant of this disease is peptic esophagitis (reflux esophagitis).

Chronic esophagitis is accompanied by pain in the chest and in the epigastric region, often combined with gastritis or duodenitis, which gives a varied clinical picture. Patients complain of a soreness behind the breastbone immediately after swallowing food; pains may also appear that do not depend on food intake, especially while running, jumping or forced breathing.Sometimes pain occurs when lying on your back, they can be in the form of seizures and radiate to the neck, back or heart area. In most cases, belching with air or with an admixture of gastric contents after eating and exercise is observed, complaints of heartburn, especially in the evening and at night; nausea, vomiting, hiccups, salivation, shortness of breath are also possible. Hiccups usually start after belching and continue for a long time.

During chronic esophagitis, there are periodic exacerbations and remissions.If treatment is started late and the esophagitis progresses steadily, cicatricial changes in the esophagus may form.

90,000 how to beat hiccups – Moscow 24, 09.09.2011

There is probably no person in the world who has never complained of hiccups in his life. This condition occurs from time to time in each of us. How to deal with hiccups – in the material M24.ru.

What is a hiccup? Speaking in medical terms, we usually hiccup when the stomach lining is irritated.As a rule, this happens when we eat a lot of raw carrots, brown bread, without washing it down with water or croutons. Although everyone has their own irritants and you will not find a universal answer for all those who suffer.

However, hiccups can also be a symptom of serious and even life-threatening conditions. For example, heart or kidney failure.

In this case, no folk remedy will help, but the disease that caused you to start hiccuping will have to be eliminated.

Sometimes hiccups occur without any external reasons at all and can last for years.The world record was set by the American Charles Osborne, who hiccupped from 1922 to 1991, that is, all his life.

So, what to do if you start to hiccup and don’t feel like going to the doctor? There are many popular ways to get rid of an unpleasant reaction of the body. The most popular of these is to scare the hiccuping person with some unexpected action. For example, sneak up from behind and sharply slap him on the shoulder with your hand. Will the hiccups stop from this or not – only the theory of probability knows. Some are said to have helped.However, the method is not without risk, the hiccups may and will pass, but only a frightened person may start to stutter, which is even worse. However, if you are a fan of treating shin blisters with leg amputation, then why not?

There is another, no less popular way. You need to draw full lungs of air and, as you exhale, blur out some tongue twister.

“Sasha walked along the highway and sucked drying”, “Hiccups, hiccups go to Fedot, from Fedot to Yakov, from Yakov to everyone.” Anyone will do. The method sometimes helps, but the harm from it will definitely be less than from fright.

If you don’t want to torment yourself with fright and tongue twisters, you can torture your own throat with ice water. Drink cold water in small sips between hiccups and it will recede pretty quickly. The method is not recommended for those who often suffer from sore throats and laryngitis, since this is a sure way to the next ENT disease.

Alcohol tincture diluted with water will also help. And if you also warm it up, the remedy is generally excellent. True, you cannot recommend it to children in any way, alcohol after all.

Oddly enough, very acidic foods are an excellent remedy for hiccups. Of course, we cannot advise you to drink sour milk, but taking a lemon wedge in your mouth and holding it there for a few minutes is an excellent method to combat hiccups.

If you don’t want to torment yourself with sour or bitter ones, you can try sugar. It is enough to put a briquette of refined sugar on your tongue and wait until the sugar is completely dissolved. This is also a folk remedy for hiccups. By the way, quite popular.

You can stick your tongue out of your mouth and hold the tip of your tongue with your fingers. According to rumors, this method was used to combat hiccups by the personal physician of US President John F. Kennedy. Finally, you can just ignore the hiccups. In some cases, when hiccups are caused by neuroses, this method will be the most effective of all.Remember that for almost every disease there is a folk remedy and in some cases it will give a hundred points of head start to various “luminal” and “veronal”.

90,000 The first signs of a stroke | Ministry of Health of the Khabarovsk Territory

FIRST SIGNS OF STROKE

(for the population)

Tatiana Anatolyevna Shcherbonosova

Head of the Department of Nervous Diseases and Psychiatry,

KGBOU DPO Institute for Advanced Training of Healthcare Professionals

Gorbulina Svetlana Vladimirovna

Assistant of the Department of Nervous Diseases and Psychiatry,

KGBOU DPO Institute for Advanced Training of Healthcare Professionals

Stroke – sudden disturbance of blood circulation in the brain, blockage or rupture of a vessel in the brain.With a blockage of blood vessels, an ischemic stroke occurs, with a rupture – a hemorrhagic stroke. It is considered to be the most common brain disease in the adult population. Moreover, with age, the risk of stroke increases significantly. According to statistics, a stroke affects 0.1 – 0.4% of the population per year, depending on the country of residence. Stroke is the leader among the causes of human disability and ranks 3rd among the causes of mortality in the population.

Scientific studies have shown that earlier stroke affects men, but the female half of humanity suffers a lot from this disease.Therefore, everyone needs to know the first signs of a stroke in order to provide timely assistance to a sick person, because delay in this case is unacceptable.

Stroke – acute cerebrovascular accident

Even before the active development of a stroke, the patient may show signs of a transient disturbance of the blood circulation in the brain.

Precursors of stroke:

– a person feels a sudden and inexplicable headache.It does not appear due to stress or some other explainable reason;

– dizziness appears, coordination of movements or balance is lost;

– some part of the body may become numb: tongue, face, arm or leg, trunk. This phenomenon is present on one side of the body, on the right or on the left, and is accompanied by weakness;

– unexpected deterioration of vision. It becomes difficult for the patient to see, both with one and with two eyes;

– consciousness and orientation in the environment are disturbed;

– there may be a speech disorder.

The above sensations appear abruptly and disappear after a few minutes or hours. And if such attacks are repeated regularly, then a person develops a stroke of varying severity within a year. No need to wait for everything to end soon, you should immediately call an ambulance.

Before the arrival of the ambulance, you need to do the following:

– to calm the patient down and put him to bed. It is advisable that he turned his head to one side. If the person is agitated, constantly persuade him to calm down.Until the arrival of doctors, it cannot be moved to another place;

– Place a towel soaked in cold water on the head of the stroke victim. An ice pack or any frozen food will also work;

– measure blood pressure. If it is high, you need to give the patient a drug that lowers the pressure, but the drug should be the one that the patient usually takes;

– to create fresh air access to the room. It is necessary to immediately remove the patient from the stuffy, especially smoky room.Be sure to open the windows, unbutton the clothes that restrict breathing – you need as much air as possible.

To check that these are signs of a stroke, you can conduct a simple test: ask to smile if half of the face remains motionless – this is a stroke. Ask to keep your hands up, if the muscles are weak, this will not be possible, ask to repeat a simple phrase, if you cannot repeat after you, then there are problems with articulation and this is an acute attack of circulatory disorders.Ask to stick out your tongue – its tip deviates towards the focus in the brain if there is a stroke. If such symptoms occur, it is an ischemic stroke, the symptoms of which are unambiguous and suggest impaired blood circulation in the brain. The sooner emergency medical care is provided, the more favorable the prognosis of such a serious illness will be. It is optimal if you seek help within 2-3 hours after the onset of the attack.

Difference between stroke and its causes in women, from stroke in men .

Stroke affects women mainly after 60 years, while in men the risk appears after 40 years. It was previously believed that stroke is the fate of older people and women, stroke is less common than men, and that after 60 years of age the risk is the same in both men and women. However, at the age of 18 – 40, women began to have a stroke more often than men. Pregnant women are also more likely to have a stroke. Young women often ignore the symptoms of transient ischemia. Strokes are harder for women than for men.Stroke deaths in women are higher than in men. A smaller percentage of women are able to return to the previous rhythm of life after a stroke, men cope better with this. The “unconventional” early first signs of stroke may occur more frequently in women than in men. The well-known risk factors in women are added – taking oral contraceptives, the pathological course of pregnancy, migraine pains, women have a higher predisposition to thrombosis and vascular complications. Women with frequent mood swings, not stress-resistant, unbalanced, with a tendency to dwell on problems are more prone to cerebral strokes.Women who smoke over the age of 30 and use contraception have a 22 percent increased risk of stroke. In recent decades, there have been very frequent cases of severe ischemic strokes associated with the popularity of such a method of contraception as oral contraceptives.

Signs of stroke in women.

Symptoms of the disease, both in women and in men, will primarily depend on the part of the brain that has been attacked by the disease.If its right side is affected, then the symptoms of the disease appear in the left half of the body and, conversely, with damage to the left side of the brain, changes are felt on the organs that are on the right.

The main symptoms of stroke in women are as follows:

– unbearable headache for no good reason;

– the face begins to grow numb, there is a weakness of the facial muscles;

– leg and arm go numb on one side of the body;

– a woman is unable to gesture;

– speech is disturbed, the patient cannot say a word or speaks indistinctly, she also cannot understand what is being said to her;

– vision is impaired, up to its loss, this is especially true for one eye.Can see double;

– coordination of movements is impaired;

– there may be a sharp loss of balance, cramps appear in the legs, arms or the other half of the body;

– the patient may fall, as inexplicable dizziness appears;

– with a stroke, depression may develop and a woman cannot control her emotions – she cries or laughs for no reason;

– nausea appears, up to vomiting, hiccups, temperature rises, swallowing functions are impaired;

– there may be a loss of consciousness for a short period of time.Before this, the woman’s face turns red, she begins to breathe often and deeply, the pulse decreases, and the pupils stop responding to light.

Signs of stroke in men.

The main symptoms of the disease in males are almost the same as in women and include:

– unbearable sudden headache, accompanied by dizziness;

– a sharp weakness appears, which cannot be explained by anything;

– the affected part of the body begins to grow numb.If the stroke is left-sided, then pain and numbness is felt in the right side of the body, and if the disease has touched the right side, then numbness with pain is present on the left;

– there may be visual impairment and speech disorder;

– very often there are convulsions, nausea, turning into vomiting, fever, loss of consciousness and even coma.

Also, specialists have identified atypical symptoms. These include dry mouth, sternum pain, mental disorders.Separately, they do not cause suspicion of apoplectic stroke, but in combination with the typical ones, they give serious grounds for immediate medical attention.

Symptoms of hemorrhagic stroke in young people.

This disease affects not only people of mature age, it also develops in young people. This is affected by the rupture of an aneurysm of the cerebral vessel, this phenomenon is most often observed at a young age. Hemorrhage occurs in the lining of the brain and a headache appears so severe that a person screams from unbearable pain sensations.Then vomiting and loss of consciousness begins, but then the patient regains consciousness. Such patients feel constant drowsiness and lethargy, which do not leave them for several days in a row, while the head hurts severely, vomiting is possible, but there is no paralysis.

Proper nutrition and a healthy lifestyle will help prevent stroke

Not a single person on the planet is immune from terrible diseases or premature death. But everyone has the ability to prevent trouble.In the case of stroke in women, especially young women, experts recommend adhering to the following recommendations. Some of these helpful tips will help prevent stroke not only in women, but also in men of all ages:

– reduce the consumption of salty and fatty foods;

– refrain from smoking and the simultaneous use of hormonal contraceptives;

– in case of diabetes mellitus, it is necessary to carefully monitor the blood sugar level;

– do not abuse alcohol and energy drinks;

– go in for sports or do exercises daily;

– monitor sleep patterns – lack of sleep can also lead to poor blood circulation in the vessels of the brain;

– monitor weight – extra pounds push the body to a variety of diseases;

– Eat more fruits and drink plenty of clean water.

Fragment of the article “Lie down or be treated”,

“Rossiyskaya Gazeta”

of April 23, 2015, No. 86 (6657)

90,000 Doctors named the main symptoms of coronavirus in children :: Society :: RBC

Photo: John Moore / Getty Images

The main symptoms of COVID-19 in children are fever, diarrhea and vomiting.This is stated in a study by a group of pediatricians conducted in four hospitals in western China. His results are published in Plos Medicine.

According to a study, fever or fever occurs in 76% of children infected with coronavirus. 62% of infected children also had a severe cough, and another 12% had diarrhea and vomiting. Lung problems in minors appear at later stages of the disease, it follows from the analysis.

In the course of the study, pediatricians examined 34 children aged from one month to 12 years.The analysis was carried out in the period from January 27 to February 23 of the current year. All patients in the current study had mild (18%) or moderate (82%) COVID-19.

Coronavirus pandemic. Most relevant for April 20

Earlier, in April, Rospotrebnadzor reported that children carry coronavirus infection more easily than adults.At the same time, they remain active carriers of the virus longer, the department warned. Children six to seven years old are the most vulnerable to COVID-19 among minors, the ministry said.

90,000 High blood pressure: does it have external signs?

Claudia Hammond
BBC Future

November 26, 2014

Photo author, Thinkstock

It is generally accepted that red-faced people who are overweight and prone to sweating have high blood pressure.But is everything as simple as it seems to us? Correspondent

BBC Future found out what science knows about this, and if we can rely on this knowledge.

You have probably seen some agitated stranger running down the street – puffy, puffy and with a red face – more than once. This spectacle inevitably makes you think that the unfortunate person probably suffers from high blood pressure. Maybe by looking at him, you will even promise yourself to appear in the gym more often.

If we are talking about your friend or colleague, who, moreover, begins to complain of headaches and nosebleeds, then you may be worried that these symptoms were not precursors of a heart attack or stroke. But can you actually recognize the signs of high blood pressure just by looking at a person?

A person blushes when blood vessels close to the skin dilate to allow more blood to pass through. Sometimes the blush appears on the face suddenly, and the person suddenly becomes hot – for example, from shame or embarrassment.And sometimes the face turns red gradually – this process takes up to 20 minutes, and it can also be caused by embarrassment or heat, cold and intense physical activity. In all these cases, the person has a temporary increase in blood pressure, but the blush caused by cycling uphill, walking in frosty weather, or unexpected meeting with a former life partner is by no means a sign of persistent hypertension.

If facial redness persists, it may be a sign of rosacea, a skin condition associated with chronic inflammation of the small blood vessels.High blood pressure can complicate the course of this disease, but people with rosacea are not always hypertensive.

Eccrine sweat glands are found in especially large numbers on the face, as well as on the palms, feet and in the armpits. Their work is regulated by the sympathetic nervous system, which is also responsible for the body’s reaction to the detected danger and for our decision about whether to fight or run away. Excessive sweating, or hyperhidrosis, can be hereditary or be indicative of a number of other conditions – but not hypertension.

Photo author, Thinkstock

Caption,

Excessive sweating can be a sign of other diseases, not hypertension …

The body reacts in a certain way even in cases where a stressful situation does not imply a threat to life. Hurrying home and running late for the bus or having a falling out with a friend can also cause heart palpitations and high blood pressure. However, once you get home and make up with a friend, these symptoms quickly disappear.

The relationship between stress and increased blood pressure is very complex, and if, under the influence of stressful situations, a person’s blood pressure often rises, this can contribute to the development of hypertension. But if a person gets angry from time to time, this does not at all betray hypertension in him.

And the head?

But what about pressure headaches? Previously, doctors thought they were caused by hypertension, but recent evidence suggests the opposite effect. When measuring pressure, two indicators are always taken into account.The upper one is systolic pressure – this is the pressure in the arteries during the contraction of the heart muscle. Research has shown that people with high systolic blood pressure are much less prone to headaches, and those with a higher difference between the upper and lower values (pulse pressure) are also less likely to suffer from headaches. And Brazilian scientists have found that people with high blood pressure have a lower risk of developing migraines.

Interestingly, blood pressure medications are often used effectively to treat migraines.According to one of the versions, the pain in this case is reduced not due to a decrease in pressure, but due to a side effect of the drug.

By the way, this applies not only to headaches and migraines. Recently in Norway, a study was conducted with the participation of more than 17,000 people – over the course of several years, scientists observed which of them would develop back pain. A third of the participants faced this problem, but it was noticed that the higher their systolic and pulse pressure, the lower the risk of pain.

This reduced pain sensitivity due to high blood pressure is called hypertension-related hypalgesia. This phenomenon also allows us to understand why some women in late pregnancy stop migraines – during this period, their blood pressure naturally rises. No one knows for sure the mechanism of development of hypalgesia in hypertension, but according to one version, the thickening of the walls of blood vessels due to increased pressure interferes with the normal activity of nerve endings, and the pain is dulled.

This does not mean that hypertension is beneficial, but it seems that some symptoms, including headaches, are more a sign of normal rather than high blood pressure.

If headache is not an indicator of high blood pressure, then what about nosebleeds? Research results on this subject appear to be contradictory. For example, Austrian scientists found that patients who were admitted to the emergency department of the Vienna Hospital with complaints of persistent nosebleeds, the pressure was indeed higher than the rest.However, studies carried out in Brazil found no connection between these phenomena.

Author of the photo, Thinkstock

Caption,

Headache quite often has nothing to do with your blood pressure

However, these studies were aimed exclusively at people who suffered from nosebleeds. But in order to find out whether this problem really indicates high blood pressure, it is necessary to understand how often it occurs among hypertensive patients. In Greece, a study was conducted among patients admitted to hospital in an acute condition caused by high blood pressure.It turned out that persistent nosebleeds are observed in only 17% of them. It appears that in some patients, bleeding may be a sign of increased blood pressure, but most people do not.

The simplest answer to all these questions is that hypertension can often be asymptomatic – with one important caveat. If the pressure rises sharply to a dangerous level, the person usually experiences severe anxiety, acute headache and dizziness, he suddenly does not have enough air.These symptoms may indicate a serious health problem and should not be ignored.

However, this is rare. In 90% of cases, the exact cause of hypertension is unknown. The only way to diagnose persistent hypertension is to take blood pressure regularly.

Hiccups and fever: The request could not be satisfied

Persistent hiccups an unusual COVID-19 symptom

The case report

COVID-19 clinical characteristics

COVID-19 signs and symptoms

Global situation

Persistent Hiccups as a Rare Presenting Symptom of Pulmonary Embolism

Abstract

INTRODUCTION

CASE DESCRIPTION

Patient # 1

Patient # 2

Patient #3

DISCUSSION

CONCLUSION

Acknowledgments

Footnotes

REFERENCES

Hiccups: Causes, treatment, and complications

Fast facts on hiccups

Lifestyle factors

Medical conditions

Tips for getting rid of hiccups

Medications

Surgery

Hiccups: Causes, treatment, and complications

Fast facts on hiccups

Lifestyle factors

Medical conditions

Tips for getting rid of hiccups

Medications

Surgery

Hiccups: Causes, treatment, and complications

Fast facts on hiccups

Lifestyle factors

Medical conditions

Tips for getting rid of hiccups

Medications

Surgery

Hiccups: Causes, treatment, and complications

Fast facts on hiccups

Lifestyle factors

Medical conditions

Tips for getting rid of hiccups

Medications

Surgery

Are Hiccups A Sign Of Covid-19 Coronavirus? Here Is What Happened In This Case

Science: Science and technology: Lenta.ru

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