A 47-yr-old woman comes to the office because of an 8-wk history of a cough. She says the cough is never productive, occurs at all times of the day (including at night), and is independent of activity. She is not sure whether she had an upper respiratory tract infection preceding the cough. She does recall that a new neighbor, who is a smoker, moved into a downstairs apartment at the time the cough began. The neighbor frequently smokes outside the patient's apartment window, triggering the cough.
She has not noticed any heartburn or runny nose. One month after the cough started, she noticed pain at the right side of her breastbone occurring with stretching and deep breathing. At that same time, she also noted that she has been wheezing during exertion. She has never had wheezing before. She has had no shortness of breath.
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