What is considered hemoptysis and where does the blood come from?
Hemoptysis is the discharge of blood and sputum from the respiratory tract below the vocal folds. It is important to distinguish it from two similar situations. With a nosebleed, blood flows down the back of the throat and is coughed up, and with bleeding from the stomach or esophagus, it is vomited, often dark, the color of coffee grounds. Pulmonary blood is usually bright scarlet, foamy, mixed with sputum and appears precisely when coughing. Specifying the source is the first step the doctor takes.
- Streaks of blood in mucous sputum
- Pink frothy sputum
- Rusty color of sputum due to pneumonia
- Blood clots when coughing
- Copious discharge of scarlet blood is a threatening condition
Possible reasons
The most common cause of single streaks of blood is damage to small vessels of the mucous membrane during severe coughing due to bronchitis or acute infection. But the list of possible causes is wide, and in Uzbekistan we must not forget about tuberculosis. In smokers over forty years of age, any recurrent hemoptysis necessarily requires the exclusion of a tumor. A separate group of causes is associated not with the lungs, but with blood vessels and blood clotting: pulmonary embolism, taking anticoagulants, heart disease.
- Acute and chronic bronchitis, severe cough
- Pneumonia and lung abscess
- Pulmonary tuberculosis
- Bronchiectasis
- Tumors of the lungs and bronchi
- Pulmonary embolism
- Nosebleeds and throat diseases
- Taking blood thinners
Associated signs that are important to the doctor
It is not the fact of blood itself that helps the doctor, but the surrounding circumstances. A prolonged cough with weight loss, evening temperature and night sweats makes one think about tuberculosis. Sudden shortness of breath with chest pain after a long period of immobility is a sign of thromboembolism. Purulent sputum with an unpleasant odor is characteristic of bronchiectasis and abscess. Try to remember in advance how much blood there was, how long it lasted, what you were taking and whether there were any injuries: these details speed up the diagnosis.
- Duration and amount of blood
- Fever, sweating, weight loss
- Shortness of breath and chest pain
- Character and smell of sputum
- Smoking and its history
- Contact with a patient with tuberculosis
- Medicines taken
What examinations are needed
The examination begins with an examination, measurement of blood oxygen saturation and a chest x-ray. If the picture does not explain the situation, and hemoptysis recurs, a computed tomography scan is prescribed - it shows bronchiectasis, small tumors and lesions much more accurately. Sputum is examined for Mycobacterium tuberculosis and normal flora. A complete blood count and coagulogram help evaluate anemia and coagulation. Bronchoscopy is used to examine the bronchi from the inside and stop bleeding.
- Chest X-ray in two projections
- Computed tomography of the lungs
- Sputum analysis, including for Mycobacterium tuberculosis
- General blood test
- Coagulogram
- Bronchoscopy according to indications
- Examination by an ENT doctor to exclude a nasal source
What to do and how to treat it
Before visiting a doctor, remain calm, do not take hot baths or warm up your chest, and do not take blood-thinning medications unless prescribed. If there is heavy bleeding, you should lie on your side on the side of the suspected lesion, do not try to hold back your cough and immediately call an ambulance by number 103. Further treatment is aimed at the cause: antibiotics for infection, anti-tuberculosis therapy, endoscopic bleeding control, bronchial artery embolization or surgery.
- Do not delay your visit even with single veins
- Quitting smoking
- Treatment of the underlying disease under the supervision of a physician
- Reviewing the dose of anticoagulants only together with your doctor
- In case of massive bleeding - call 103
- Control examination after completion of treatment