Coughing Up Blood: What It Can Be And What To Do, Reasons, Video

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2024-01-15 19:51

Coughing up blood: causes, diagnosis, first aid

The content of the article:

1. Why does coughing up blood appear
2. Associated signs
3. Diagnostics
4. What to do with pulmonary bleeding
5. Treatment
6. Video

Coughing up blood (hemoptysis, hemoptysis) is a pathological condition when a person coughs up blood (in the form of bloody spit, scarlet blood) or mucus streaked with blood during a cough.

Coughing up blood accompanies various diseases, and not only the respiratory tract

Why does coughing up blood appear

According to medical statistics, among therapeutic patients, hemoptysis occurs in 60-70% of cases against the background of colds, bronchitis or pneumonia. During a severe attack of coughing, the wall of a blood vessel in the bronchial mucosa can rupture, and a small amount of blood enters the respiratory tract, from where it is coughed up as streaks in sputum. In this case, coughing up blood does not pose a serious danger, since after the acute inflammatory process subsides, it disappears without any consequences.

Another cause of this symptom is thromboembolism (blockage by a blood clot) of the pulmonary artery or its branches.

Other causes of hemoptysis can be many other pathologies of the respiratory system:

• tuberculosis;
• bronchiectasis;
• lung abscess;
• traumatic lung injury (blunt chest injury, rib fracture);
• cystic fibrosis;
• amyloidosis of the lung;
• iatrogenic damage during diagnostic or therapeutic procedures (bronchoscopy, pulmonary artery catheterization, transbronchial biopsy).

The appearance of coughing up blood is not in all cases associated with diseases of the bronchopulmonary system. A common cause of its occurrence is diseases of the ENT organs (sinusitis, frontal sinusitis, tumors of the pharynx or larynx).

Heart failure can also be accompanied by hemoptysis. This is due to stagnation of blood in the vessels of the pulmonary circulation and an increase in pressure in them.

Associated signs

Depending on the underlying disease, coughing up blood can be combined with various symptoms.

Disease	Associated symptoms
Bronchitis	The patient has a cough with mucous or mucopurulent sputum, in which blood streaks may be present. The body temperature is elevated.
Pneumonia	Patients complain of high body temperature, severe general weakness, shortness of breath. When coughing, rusty phlegm is coughing up, but sometimes small streaks of scarlet blood may be present in it.
Lung abscess	Hectic-type fever, chest pain, lack of appetite. The phlegm is offensive, purulent with blood.
Bronchiectasis	In this case, the cough persists for a long time. The phlegm is purulent, periodically an admixture of blood appears in it.
Pulmonary tuberculosis	A sick person has poor appetite, weakness, increased sweating, weight loss, low-grade fever. Sputum purulent with blood.
Lung cancer	Characterized by the presence of pain in the chest area, increasing weakness, lack of appetite, dramatic weight loss. The cough with profuse expectoration persists for a long time. When the tumor grows into the blood vessels, their integrity is damaged and blood appears in the sputum (from minor inclusions to massive pulmonary hemorrhage, life-threatening).
Chronic heart failure with symptoms of stagnation in the pulmonary circulation	A cough with blood streaks appears under the influence of physical exertion. As the disease progresses, it begins to occur at night when a person is in a horizontal position.
Thromboembolism of the branches of the pulmonary artery	Suddenly there are severe chest pains, and after a few hours they are joined by coughing up blood.
Cystic fibrosis	The patient often has acute respiratory diseases. The cough is accompanied by coughing up of very viscous purulent sputum with blood impurities. In addition, patients also suffer from diseases of the gastrointestinal tract.
Traumatic injuries of the respiratory system (postoperative trauma, after bronchoscopy, biopsy)	These conditions are characterized by a cough with expectoration of scarlet clots.

Diagnostics

Coughing up blood can be a symptom of life-threatening diseases, so when it appears, you should definitely see a doctor for a medical examination.

Diagnostics includes the following methods:

1. Chest X-ray. The appearance of darkened areas in the lungs is a sign of pneumonia, lung cancer, thromboembolism of the branches of the pulmonary artery. An indirect sign of cardiac diseases can be an increase in the size and shape of the heart shadow.
2. Bronchoscopy. The most informative method in the diagnosis of lung cancer and bronchiectasis.
3. Computed tomography of the chest. Allows you to clearly determine the location and extent of the spread of the pathological process.
4. Sputum analysis. With tuberculosis, Koch's mycobacteria can be found in sputum. A high content of pathogenic microorganisms in bronchial mucus is observed in bronchitis, pneumonia, lung abscess, bronchiectasis.
5. Sweat analysis for electrolyte content. It must be done if cystic fibrosis is suspected.
6. Complete blood count. Objective indicators of the inflammatory process in the lungs are leukocytosis and increased ESR (erythrocyte sedimentation rate), shift of the leukoformula to the left. With malignant tumors in the general blood test, anemia, increased ESR are noted.
7. Coagulogram. With its help, the state of the blood coagulation system is assessed.
8. ECG and Echo-KG. They allow to identify myocardial ischemia, heart rhythm disturbances, to assess the contractility of its various departments.
9. FEGDS. This research method is indicated to exclude pathologies of the esophagus and stomach.

What to do with pulmonary bleeding

If, when coughing, sputum with a small admixture of blood is separated, then the patient should contact a local therapist at the clinic. The doctor will conduct an initial examination, and then, if necessary, refer the patient for consultation to narrow specialists (cardiologist, pulmonologist, phthisiatrician, oncologist).

In this case, an ambulance team is called. Before the arrival of the doctor, the person is given a sitting or semi-sitting position and offered to dissolve small pieces of ice. It is important that the patient spits out all the released blood into a special container - it must not be swallowed, as this can provoke vomiting, during which vomit can enter the respiratory tract (aspiration of vomit).

Treatment

The method of treatment of hemoptysis is determined by the cause that led to its occurrence. In case of lung cancer, the doctor, based on the characteristics of the clinical situation, may prescribe surgical, chemotherapy, radiation, or combined treatment.

One of the causes of hemoptysis is pulmonary tuberculosis

In cases where hemoptysis occurs against the background of a cavernous form of tuberculosis, the patient is prescribed therapy with several anti-tuberculosis drugs simultaneously.

Treatment of hemoptysis against the background of bronchitis, pneumonia is carried out with antibacterial drugs.

With bronchiectasis and lung abscess, surgery may be required.

Video

We offer for viewing a video on the topic of the article.

Elena Minkina Doctor anesthesiologist-resuscitator About the author

Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.

Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.

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