During the cold and flu season, many people develop chest congestion and a cough. The cause of a cough is usually due to excess mucus in the airways. Anyone can develop a cough and while it is usually attributed to a cold or the flu, it can also be caused by smoking, asthma, or other airway obstruction diseases. Coughs can be treated with over the counter medications but if they are severe or do not go away after several weeks, a doctor may need to be consulted. There are stronger, prescription medicines that can treat a cough. It is always a good idea to drink plenty of fluids to thin the mucus when you have a cough.


“I just have a little cough,” you say. And in the vast majority of cases, you’ll be right. But what about those times where your cough is only an early warning—a symptom of something potentially far worse? How can you tell the difference, while you still have time to do so? And when you begin to suspect your little cough of being not-so-little, what should you do?

Symptoms to Alert You

A cough alone, for a brief period of time, is almost meaningless. Only when other conditions begin to be met should you take serious notice and consider seeing a healthcare professional.


One of the simplest symptoms to accompany more dangerous coughs, one all too often overlooked with the excuse “I smoke” or “I’m out of shape.” When coughing leaves you short of breath, it’s something deserving your attention. Even if it is, ultimately, just a reminder of lack of fitness or smoking, it’s a sign of poor health and deserving of medical attention. And it might be an early sign of COPD, or even heart failure.

Lasts multiple weeks

A persistent cough isn’t necessarily something to worry about. A persistent cough still hounding you weeks down the line probably deserves a little attention—if nothing else, coughing incessantly for that long is going to leave you sore and annoyed. And it’s probably not a great idea to be taking cough suppressants indefinitely. So consider unusually prolonged coughing a problem.

Excessive or unusual phlegm

When you find yourself spitting up thick phlegm, large amounts of it, or phlegm of an unusual color, be worried. Blood in your phlegm might be nothing—the result of a minor nosebleed or abrasion—or something quite serious. Similarly, coughing up bright green sputum can indicate a mild infection, more than capable of clearing itself up, or something quite serious, demanding immediate medical attention. Take weird phlegm seriously.


Wheezing accompanying a cough can indicate any number of problems, from asthma to pneumonia, none of them good. Wheezing isn’t something you’ll want to leave unattended for long; if it’s just mild bronchitis, perfect, you’re fine, but you’ll want to know that before you ignore something potentially obstructing your airways.


If your cough comes with a sense of fatigue no amount of rest seems to shake, it might be time to hit the doctor. You might have a viral infection or other problem taxing your immune system, or any of a number of other problems.


It’s rarely a good idea to ignore a fever to begin with, so take fevers combined with coughs very seriously. Lots of conditions can cause fever; some mild, some very, very dangerous to your health. Skip the rest and see a doctor if you have a high fever and a cough, lest you find yourself in poor condition indeed.

Chest pain

Chest pain isn’t necessarily something serious, especially if you’ve been coughing for a while. After all, muscles and tendons and various tissues get sore after that much aggravation. But sometimes, chest pain indicates worse problems. Maybe you have GERD—you’d be surprised, but digestive problems can manifest in strange ways. Or you might be suffering heart failure or similarly serious conditions. So take chest pain seriously, even though it’s probably nothing.

Conditions to Consider

When you reach the tentative conclusion that something’s wrong, there are quite a few conditions to consider as likely culprits. This list isn’t meant to be exhaustive, or to be of much use in self-diagnosing. Rather, it’s to impress upon you how serious a cough can turn out to be.

Viral infections

One of the most common sources of a persistent cough paired with other symptoms, viral infections can vary in danger from your typical annoying cold to potentially deadly cases of influenza. If you suspect a virus, see a doctor.


Chronic obstructive pulmonary disease, or chronic obstructive lung disease, can cause a number of lung-related symptoms, characterized by coughing, fatigue, shortness of breath, and excessive sputum production. Left untreated, it will only get worse with time.

Bacterial pneumonia

Bacterial pneumonia is in infection of the lungs, and is potentially lethal. Treat fever, coughing, and weird phlegm as a sign to see your doctor as soon as possible.


AKA acid reflux or reflux disease, GERD causes heartburn, coughing, fevers, and a host of other seemingly unrelated ailments—but mostly, you’re going to notice the heartburn. See a doctor before the damage gets too bad.

Lung cancer

Basically any lung-based symptom can be indicative of lung cancer—even a cough by itself. If you have a family history of cancer, be vary alert to this possibility, as early treatment is vital.


Shortness of breath, wheezing, chest tightness, and frequent coughs point to asthma, especially if you’re getting the worst of your symptoms at night or after exercise. Asthma can get worse, and can be very dangerous untreated, so take these symptoms seriously.

Congestive heart failure

It might surprise you to see this on the list, but heart failure can cause a lot of symptoms in the nearby lungs and gastrointestinal system. Chest pain, fatigue, swelling of your limbs, and other symptoms can point to heart failure.

Smoking, allergies, etc

Plenty of reasons to cough aren’t a huge deal…but if you’re coughing all the time because of allergies, or smoking, or other concerns, it’s worth taking a moment to figure out a solution.

Actions to Take

Ultimately, there’s a single action worth taking when you suspect you have any serious health issue, cough-related or otherwise: Go to the doctor. If it’s nothing, it’s nothing. If it’s serious, you might just be saving your own life with your attentiveness. If you want to improve your odds of an accurate diagnoses, however, consider making a journal of your symptoms in the time leading up to your visit.

Log symptoms as they occur, along with health information such as what you ate, environmental factors, what you were doing at the time, what medicines you were taking, etc. The more information you can put in front of your doctor when you see him or her, the more accurate their diagnosis will be—and the less likely you are to walk out with a shrug and a “Quit smoking, and let’s see if that helps.”

You don’t want to have to wait to find out if that cough really is just a cough.