- 1 What is Hemoptysis?
- 2 Hemoptysis causes
- 3 Hemoptysis signs and symptoms
- 4 Evaluation of Hemoptysis
- 5 Hemoptysis Differential diagnosis
- 6 Management of massive Hemoptysis
- 7 Medicolegal concerns
- 8 Hemoptysis Treatment
- 9 Hemoptysis Home care
What is Hemoptysis?
Hemoptysis is coughing up blood or sputum with blood strain. This is often described as a serious condition of the lungs or other related organs including trachea, bronchi and larynx. So in general, Hemoptysis is a form of tuberculosis or respiratory infection. In this disease, blood comes out of mouth or nose of the patient.
There are mainly two types of Hemoptysis: mild and massive. The mild Hemoptysis is not very dangerous and most of the times, the nonsmokers are the victim of this infection. This is easily treatable and does not cause any permanent damage to the body. On the other hand, the massive Hemoptysis is an emergency medical condition and requires professional treatment. Most patients, who died because of the massive Hemoptysis, are because of too much blood consuming in the airways.
Hemoptysis can be caused for many reasons. Among them, bronchitis and pneumonia are most common. Other than these two, the other reasons for Hemoptysis are the following:
- Lung cancer
- Aspiration pneumonia
- Goodpasture’s syndrome
- Wegener’s granulomatosis
- Pulmorary embolism
- Anticoagulant use
- Lung abscess
- Mitral stenosis
Also there are some rare causes that can cause Hemoptysis, like the hereditary hemorrhagic teleangiectasia. Another rare result is catamenial Hemoptysis which is caused by thoracic endometriosis. In children, attack of foreign micro organic substance in the respiratory tract causes the diseases.
Hemoptysis signs and symptoms
The primary and most significant sign of Hemoptysis is blood coming out of mouth or nose. A minor reason, like an injury may cause the blood too. So be sure, the history of blood coughing is important. In the primary stage, there may be several other symptoms along with frank Hemoptysis. If the patient has other illness in parallel to Hemoptysis, like cancer, the symptoms may change. Because of these reasons, the symptoms usually vary over patient to patient. The most common signs of a Hemoptysis patient are:
- Chest pain
- And Trouble in berating.
Another similar disease called hematemesis has similar symptoms including blood with cough. But in Hemoptysis, the blood comes in bright red with clotted or liquid form, where in hematemesis, the blood is dark or brown.
Evaluation of Hemoptysis
To determine the treatment; the doctor has to do some initial evaluation of a Hemoptysis patient. This pathopsyciology of Hemoptysis includes total medical history of the patient, chest X-ray, upright postero anterior and integrated physical examination. The history of chronic pulmonary symptoms like sputum, cough, shortness of breathing and any lung discontinuity are very crucial. If the Hemoptysis grows along with cancer or any chronic infection, the history of fever, weight loss and sweating are important. Symptoms of heart disease, pulmonary thromboembolism and vacuities are also need consideration to find out whiter they influence the Hemoptysis.
The main focus of the physical examination is to detect any sign of infections or lung abscess, pneumonia or bronchiectasis. The exam includes COPD, locale wheezing, diffuse, local crackels and rhonchi. Cardiovascular examination identifies mitral stenosis and deep venous thrombosis.
The blood count and lateral chest X-ray help to find out the source of Hemoptysis. Cytology test on sputum revels any sign of lung cancer or similar epidemiologic source. A negative result of X-ray does not rule out Hemoptysis and if the doctor wants to go further, computer tomography of the chest can give more accurate result.
Hemoptysis Differential diagnosis
In the differential diagnosis, the doctors try to find out the root of the Hemoptysis. However, it is not always easy to find. The recurring condition and severity, as well as original reason are very important for treating the Hemoptysis. And for that, a very systematic evaluation is required. Based on the location of the patient, the causes may be changed. For example, the Hemoptysis patients in North America have less possibility of tuberculosis and bronchiectasis than the rest of the world. The inflammatory disorders are the main reasons for massive Hemoptysis as it turns into bronchial circulation, which turns the bleeding under systemic vascular pressure.
The therapy of Hemoptysis is not specific unless it is massive Hemoptysis. The doctors use different therapy based on the growth of the disease. For example, in case of infectious etiologies, antibiotic therapy is used.
Management of massive Hemoptysis
Massive Hemoptysis is the most severe condition and the patient loses over 200 ml of blood per day. In this situation, the patient needs emergency medical concentration. The treatment may even involve a surgery to remove the bleeding organ or, bronchial angiography along with embolization when feasible. However, the later one is not accepted by many specialists. Surgery is considered as the standard management in the life threatening condition of the severe bleeding in massive Hemoptysis.
The worst case scenario is when the doctor fails to determine a lung cancer. The next one is the inability to detect pulmonary thromboembolism. Failure to diagnosis the right situation may cause malpractice litigation for the physican.
When to refer or when to contact a medical professional
If there more than one teaspoon of blood in the cough, along with dizziness, shortness of breath and chest pain, it is required to see a medical professional immediately. Reference to the specialists is very critical in these situations:
- To test for computer tomography.
- To test for bronchoscopy.
- Massive Hemoptysis.
- Life threatening condition.
- Repeated undiagnosed Hemoptysis.
The treatment of Hemoptysis mostly depends on the underlying cause. Modalities like iced saline and vasoconstrictors are frequently used as well as bronchial intubation to collapse the infected lung. Laser photocoagulation works well to stop the bleeding. Surgery is the last option which is used in the massive situation.
Hemoptysis Home care
Cough suppressants are used for reducing the throat irritation; but in some case, they can make the berating difficult. If you use it in home, you need to check it from time to time and contact the doctor in case of any sign of difficulty.
Another important thing to do from home is to keep an eye for the blood in the cough. Incorrect history may lead to wrong treatment and put the patient’s life in danger.