Hemoptysis

Hemoptysis means coughing up blood from some part of the respiratory tract. The respiratory tract includes the nose, mouth, throat, airway passages, and lungs. You should always contact a caregiver if you develop hemoptysis. This is important as even mild cases of hemoptysis may lead to serious breathing or bleeding problems. Major bleeding from the airway is considered a medical emergency, and needs to be evaluated and managed promptly to avoid complications, disability, or death. Hemoptysis may reoccur from time to time.

CAUSES

In some cases, the cause of hemoptysis is not known. Causes may include:

  • A ruptured blood vessel caused by coughing or an infection.

  • Bronchiectasis. Bronchiectasis is a long-standing infection of the small air passageways.

  • A blood clot in the lungs (pulmonary embolism).

  • Pneumonia.

  • Tuberculosis.

  • Breathing in a small foreign object.

  • Cancer.

DIAGNOSIS

Diagnosing the cause of hemoptysis is important. The most common cause of hemoptysis is a ruptured blood vessel caused by coughing or a mild infection. This is normally no cause for concern. Diagnosing the cause for hemoptysis is based on your history, symptoms, physical examination, and diagnostic tests. Tests for diagnosing the cause of hemoptysis may include:

  • Blood samples.

  • A chest X-ray.

  • A computerized X-ray scan (CT scan or CAT scan).

  • Bronchoscopy. This test uses a flexible tube (a bronchoscope) to see inside the lungs.

  • Pulmonary angiography. Pulmonary angiography is an X-ray procedure that looks at the vessels in the lungs. Angiography produces a picture called an angiogram. It requires injecting a dye into the blood vessels.

TREATMENT

  • Treatment for hemoptysis depends on the cause. It also depends on the quantity of blood. Infrequent, mild hemoptysis usually does not require specific, immediate treatment.

  • If the cause of hemoptysis is unknown, treatment may involve monitoring for at least 2 or 3 years. If you have a normal chest X-ray and bronchoscopy, the hemoptysis usually clears within 6 months.

  • Treatment of a pneumonia, chronic bronchiectasis, or tuberculosis usually involves medicines to fight the infections.

  • For lung cancers, treatment depends on the stage of the cancer.

  • Major bleeding is a medical emergency. Steps are usually taken to find the source and stop the bleeding.

  • Some methods of controlling active moderate to severe bleeding include:

  • Surgical removal (resection). Tissue causing the hemoptysis is removed.

  • Bronchoscopic laser therapy. During a bronchoscopy, a laser is used to remove tumors and lesions or widen airways.

  • Bronchial artery embolization. This procedure involves injecting substances into the bloodstream to stop blood flow.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You begin to cough up large amounts of blood.

  • You develop problems with your breathing.

  • You begin vomiting blood or see blood in your stool.

  • Develop chest pain.

  • Feel faint or pass out.

  • You develop a fever over 102° F (38.9° C), or as your caregiver suggests.