Hemoptysis

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A medical term for coughing out a small amount of blood, hemoptysis, could indicate a mild or serious condition.

HemoptysisWhat is hemoptysis?

Hemoptysis is the medical term for coughing out blood or spitting blood or bloody sputum. The blood comes from the respiratory tract, generally from the throat or air passages or lungs.

Causes for hemoptysis

Hemoptysis is a symptom that may indicate a mild or serious condition. Sometimes a small amount of blood may come out due to vigorous coughing or it could indicate a cancer of the respiratory system.

  • A blood clot in the lung.
  • Chronic lung conditions like bronchitis or bronchiectasis
  • Pulmonary aspiration or breathing blood into the lungs.
  • Cystic fibrosis
  • Cancer of the respiratory tract
  • Vasculitis or inflammation of the blood vessels of the lungs
  • Injury to arteries of the lungs
  • After bronchoscopy due to injury to the air passages.
  • Pneumonia or other infections of the lung
  • Pulmonary oedema
  • Tuberculosis
  • Systemic lupus erythematosus

Symptoms and signs of hemoptysis

  • In hemoptysis, the blood is frothy as it is mixed with air and mucus.
  • Sometimes the mucus is streaked with blood; there may not be frank blood.
  • The quantity may vary with a small amount due to throat irritation or a large amount in case of cancer.
  • The blood may be bright red in colour or it may be rust coloured.
  • If the cough is accompanied by high fever, shortness of breath, dizziness, chest pain and blood in the urine or stool, get urgent medical attention without delay.

Diagnosing the cause behind hemoptysis

If you have coughed up blood, you should see your physician promptly. You will be asked questions like how much blood do you bring up, it’s colour, recent history of any illness, are you in contact with a person having tuberculosis, has the hemoptysis become worse recently, etc.. After a thorough history and examination, the physician may have a clue to the possible cause. In many cases tests are ordered to confirm the diagnosis.

Investigations conducted:

  • The ESR or erythrocyte sedimentation rate may be raised in case of tuberculosis.
  • Prothrombin time is done to check if the blood clotting function is normal.
  • Sputum culture and smear are important.
  • A chest X-ray is invaluable to diagnose a tumour and check for heart problems like an enlarged size of the heart.
  • A CT scan may be ordered if a blood clot or tumour is suspected.
  • Lung scan or a lung biopsy may be needed in case of tumours.

 Treatment for hemoptysis

  • The cause of hemoptysis has to be treated. In case of tuberculosis, which is a national health problem, a proper regimen of anti-tubercular drugs is advised.
  • If the hemoptysis is due to irritation of the throat a cough suppressant syrup can be used.
  • In case of pneumonia or other infection, appropriate antibiotic therapy is given.
  • Pulmonary oedema occurs due to heart failure and needs intensive care.

Photograph via sxc.hu

Written by Dr Nisreen Nakhoda, General Physician

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