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Hemoptysis is a medical condition in which a person coughs up blood. It can be due to a minor infection or a life-threatening medical emergency.

Complete this lesson to learn about causes, symptoms, and treatment options.

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Definition of Hemoptysis

We’ve all had bad winter colds that make us feel like we are ‘coughing up a lung,’ but what happens when that cough begins to produce blood? Hemoptysis is a condition that causes someone to cough up blood from the lungs. It can be caused by bleeding within the lungs or after a severe nosebleed. The person may cough up only blood or blood mixed with phlegm (sputum).

Symptoms can be confused with blood that is actually coughed up from the stomach rather than from the respiratory system.

Causes of Hemoptysis

There are actually a ton of possible causes for hemoptysis, so doctors have their work cut out for them trying to pinpoint the culprit. In fact, in about 25% of cases, no cause is identified at all! In the United States, the most common cause is acute bronchitis, which is when the bronchi become inflamed or swollen. These cases usually clear on their own but can progress into more serious conditions. In the rest of the world, tuberculosis, a bacterial infection of the lungs, is the most common cause of hemoptysis.Here is a list of other possible causes:

  • Bronchiectasis
  • Lung cancer
  • Benign tumors in the lungs
  • Parasitic infection
  • Use of blood thinners or other medication
  • Pneumonia
  • Pulmonary embolism
  • Congestive heart failure
  • Chronic inflammatory conditions
  • Autoimmune disorders
  • Use of crack cocaine
  • Cigarette smoking
  • Trauma
  • Foreign body lodged in the lungs
  • Dieulafoy’s disease
  • Cystic fibrosis
  • Chronic obstructive pulmonary disease (COPD)

Symptoms of Hemoptysis

Generally, coughing up blood would be alarming enough in itself to prompt one to get medical treatment. However, there are a number of symptoms that may accompany hemoptysis that indicate the possibility of a serious medical emergency.

These include hemoptysis lasting longer than a week or recurring over time, chest pains, unexpected weight loss, night sweats, fever, and shortness of breath during activities that would otherwise be non-exerting.

Diagnosis of Hemoptysis

If a patient walks in to your office and is coughing up blood, it’s time to get down to business and figure out the underlying cause. A physical exam and review of the patient’s medical history can help pinpoint causes, as can imaging scans like X-rays or CT scans. Blood chemistry, blood cell counts (platelets help with blood clotting), and analysis of the material that is being coughed up can also provide clues as to the cause of the blood.

There is also a process called a bronchoscopy, in which a small tube with a camera is fed through the mouth down into the windpipe and lungs. The camera can provide ‘eyes on the inside’ to locate the source of a bleed.

Treatment of Hemoptysis

Once hemoptysis has been diagnosed, the goal is to stop the bleeding, find the cause, and make sure the person doesn’t have difficulty breathing.

If the bronchoscopy found a tear, it’s possible to use tools attached to the tube to patch up the bleed. Another option is a bronchial artery embolization, a procedure that inserts dye into the arteries and traces its path throughout the body until the location of the bleeding is found. Then the artery can be closed off or sealed to stop the bleeding.If a bacterial infection is the cause, antibiotics and cough medicine may be prescribed.

Steroids can be injected to reduce inflammation. Cancer patients can undergo chemotherapy and radiation therapy, and people with irregular blood cell counts can receive a blood transfusion. In serious cases, a piece of the lung or an entire lung may be surgically removed.If it’s found that bleeding is coming from the nose, rinsing the nose with cold salt water might help stop bleeding. Herbal supplements can actually do more harm than good, as they can make bleeding worse.

Lesson Summary

Wow – that’s quite a bit of information on hemoptysis, which you should remember is a condition where a person coughs up blood.

Minor cases go away on their own, but severe cases can be life-threatening. There are many possible causes of hemoptysis and just as many tests used to find the cause, the most common of which in the U.S. is acute bronchitis, which is when the bronchi become inflamed or swollen, while tuberculosis, a bacterial infection of the lungs, is the most common in the rest of the world. Once the underlying cause is found, usually with processes like a bronchoscopy, in which a small tube with a camera is fed through the mouth down into the windpipe and lungs, treatment can be used to stop the bleeding, treat that cause, and ensure the person can breathe and is getting enough oxygen.

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