Cough is a defense mechanism for airway protection and is associated with multiple systemic complications such as ribs fracture. Diaphragmatic rupture is commonly caused by blunt or penetrating trauma. We presented a case of a 72-year-old female with a 1-year history of chronic cough, not responding to medical management. Imaging showing abdominal herniation into the thoracic cavity and rib fracture due to diaphragmatic and chest wall rupture. Abdominal herniation and diaphragmatic rupture were repaired through surgery allowing resolution of symptoms. This is a life-threatening condition with a high-mortality rate in which early diagnosis and repair are desirable. Therefore, awareness of this uncommon complication of cough should be acknowledged.

Scimitar Syndrome is a rare congenital disorder and a variant of partial anomalous pulmonary venous connection (PAPVC) in which part or even the entire right lung is drained by right pulmonary veins that connect anomalously to the Inferior Vena Cava (IVC). It has various presentations including exertional dyspnea, recurrent chest infection, pulmonary artery hypertension, and hemoptysis. The initial diagnosis of PAPVC may be made by echocardiography and is typically confirmed by magnetic resonance imaging, computed tomography, or cardiac catheterization.We report a 69-year-old man with progressive dyspnea on exertion associated with palpitations of five years of evolution. The patient was diagnosed with cardiomyopathy, pulmonary hypertension and was started on treatment with anticoagulation, digoxin, and metoprolol for his atrial fibrillation. Despite the treatment, the dyspnea did not improve. The patient underwent cardiac catheterization, where the anomalous venous drainage was confirmed. Scimitar syndrome was corrected by surgical intervention with complete resolution of symptoms.