Hemoptysis is the act of coughing up blood or blood-stained sputum from the bronchi, larynx, trachea, or lungs. This can occur with tuberculosis infections, other respiratory infections, or some cardiovascular conditions.
Causes
There are many potential reasons for coughing up blood. Causes for coughing blood include :
1. Bronchitis (acute or chronic), the most common cause of coughing up blood. Hemoptysis due to bronchitis is rarely life-threatening.
2. Bronchiectasis
3. Lung cancer or non-malignant lung tumors
4. Use of blood thinners (anticoagulation)
5. Pneumonia
6. Pulmonary embolism
7. Congestive heart failure, especially due to mitral stenosis
8. Tuberculosis
9. Inflammatory or autoimmune conditions (lupus, Wegener’s granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome, and many others)
10. Pulmonary arteriovenous malformations (AVMs)
11. Crack cocaine
12. Trauma, such as a gunshot wound or motor vehicle accident
13. Dieulafoy’s disease.
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Diagnostic Approach
1. History and physical examination :
- History of tuberculosis, bronchiectasis, chronic bronchitis, mitral stenosis, etc.
- History of smoking, occupational diseases by exposure to silica dust, etc.
2. Chest X-ray :
This test may show a mass in the chest, areas of fluid or congestion in the lungs, or be completely normal.
3. Blood :
- Duration, frequency, amount
- Amounts of blood: large amounts of blood, or is there blood-streaked sputum
- A test of the number of white and red blood cells in the blood, along with platelets (cells that help blood clot).
4. Computed tomography (CT scan) :
By producing detailed images of structures in the chest, a CT scan can reveal some causes for coughing up blood.
5. Bronchoscopy :
A doctor advances an endoscope (flexible tube with a camera on its end) through the nose or mouth into the windpipe and airways. Using bronchoscopy, a doctor may be able to identify the cause of hemoptysis.
Treatment
1. Treatment depends largely upon the underlying cause.
2. Many modalities of treatment can be used, like, iced saline, or topical vasoconstrictors, such as adrenalin or vasopressin can be used.
3. Selective bronchial intubation can be used to collapse lung in which the hemorrhage is occurring, also endobronchial tamponade can be used.
4. Laser photocoagulation can be used to stop bleeding during bronchoscopy.
5. Angiography of bronchial arteries can be performed to locate the bleeding, and it can often be embolized.
6. Surgical option is usually the last resort, and can involve, lobectomy or pneumonectomy.
7. Non–small-cell lung cancer can also be treated with erlotinib or gefitinib.
8. Antibiotics for pneumonia or tuberculosis, Chemotherapy and/or radiation for lung cancer.
Causes
There are many potential reasons for coughing up blood. Causes for coughing blood include :
1. Bronchitis (acute or chronic), the most common cause of coughing up blood. Hemoptysis due to bronchitis is rarely life-threatening.
2. Bronchiectasis
3. Lung cancer or non-malignant lung tumors
4. Use of blood thinners (anticoagulation)
5. Pneumonia
6. Pulmonary embolism
7. Congestive heart failure, especially due to mitral stenosis
8. Tuberculosis
9. Inflammatory or autoimmune conditions (lupus, Wegener’s granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome, and many others)
10. Pulmonary arteriovenous malformations (AVMs)
11. Crack cocaine
12. Trauma, such as a gunshot wound or motor vehicle accident
13. Dieulafoy’s disease.
Diagnostic Approach
1. History and physical examination :
- History of tuberculosis, bronchiectasis, chronic bronchitis, mitral stenosis, etc.
- History of smoking, occupational diseases by exposure to silica dust, etc.
2. Chest X-ray :
This test may show a mass in the chest, areas of fluid or congestion in the lungs, or be completely normal.
3. Blood :
- Duration, frequency, amount
- Amounts of blood: large amounts of blood, or is there blood-streaked sputum
- A test of the number of white and red blood cells in the blood, along with platelets (cells that help blood clot).
4. Computed tomography (CT scan) :
By producing detailed images of structures in the chest, a CT scan can reveal some causes for coughing up blood.
5. Bronchoscopy :
A doctor advances an endoscope (flexible tube with a camera on its end) through the nose or mouth into the windpipe and airways. Using bronchoscopy, a doctor may be able to identify the cause of hemoptysis.
Treatment
1. Treatment depends largely upon the underlying cause.
2. Many modalities of treatment can be used, like, iced saline, or topical vasoconstrictors, such as adrenalin or vasopressin can be used.
3. Selective bronchial intubation can be used to collapse lung in which the hemorrhage is occurring, also endobronchial tamponade can be used.
4. Laser photocoagulation can be used to stop bleeding during bronchoscopy.
5. Angiography of bronchial arteries can be performed to locate the bleeding, and it can often be embolized.
6. Surgical option is usually the last resort, and can involve, lobectomy or pneumonectomy.
7. Non–small-cell lung cancer can also be treated with erlotinib or gefitinib.
8. Antibiotics for pneumonia or tuberculosis, Chemotherapy and/or radiation for lung cancer.
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