In addition to the main symptoms of pulmonary disease, there are other, less common symptoms. These include the following:
• Stridor (noisy breathing)
• Voice changes
• Swelling of the ankles (dependent edema)
Stridor is a harsh type of noisy breathing and is usually associated with obstruction of a major bronchus that occurs with aspiration. Voice changes can occur with inflammation of the vocal cords or interference with the recurrent laryngeal nerve. Swelling of the ankles is a manifestation of dependent edema, which is associated with right-sided heart failure, renal disease, liver disease, and obstruction of venous flow. As the condition worsens, abnormal accumulations of fluid produce generalized edema, known as anasarca.
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