Coughing Up Blood (Hemoptysis): Causes, Tests & Diagnosis

What is hemoptysis? What is the most common cause of hemoptysis? What should you do if a patient is coughing up blood? How do you treat and manage hemoptysis?

If you’re looking for the answer to any of these questions, you’re in the right place because that is what this guide is all about. So if you’re ready, let’s go ahead and dive right in.


Hemoptysis

What is Hemoptysis?

Hemoptysis is a term that refers to the act of coughing up blood from the respiratory tract.

As a medical professional, whether you’re a nurse or Respiratory Therapist, whenever you have a patient who is coughing up blood, this finding should be taken very seriously. In fact, it should be reported to the physician right away.

Hemoptysis is often found in patients with lung cancer. It’s also common in respiratory infections such as tuberculosis, bronchitis, and pneumonia. It also occurs in certain cardiovascular conditions as well.

While hemoptysis is not always indicative of a serious condition, it’s usually worth investigating further to determine the cause of the bleeding.

What causes coughing up blood?

Causes of coughing up blood range from mild to serious. Bronchitis is the most common, and least serious, cause of coughing up blood.

Other causes may include:

  • Blood clot in the lung
  • Pulmonary aspiration (breathing blood into the lungs).
  • Lung cancer.
  • Excessive, violent coughing that irritates your throat.
  • Pneumonia.
  • Using blood thinners.
  • Tuberculosis.
  • Pulmonary embolism (blockage of an artery in your lungs).
  • Complications from lupus.
  • Congestive heart failure.
  • Irritation from a bronchoscopy biopsy.
  • Bronchiectasis (a condition that causes of enlargement of the arteries in your lungs).
  • Cystic fibrosis.
  • Vasculitis (inflammation of the blood vessels in your lung).
  • Injury to the arteries of your lungs.

How is the cause of coughing up blood diagnosed?

Since coughing up blood can range from mild to serious, it's important to diagnose the underlying cause of your symptoms so that you can be properly treated.

Your healthcare provider will begin an exam by asking how much blood you have been coughing up, for how long and how much is mixed with mucus.

The following tests may be done:

  • A computed tomography (CT) chest scan.
  • Chest X-ray to look for tumors or fluid in the lungs.
  • Lung scan.
  • Lung biopsy.
  • Bronchoscopy (a flexible tube inserted through the nose or mouth) to check if the airways are clear.
  • Blood count.
  • A sputum culture of your lung excretions to look for infection.
  • Blood clotting test.
  • Pulmonary arteriography to see how blood flows through your lungs.
  • Urinalysis.

How is coughing up blood treated?

Treatment for coughing up blood varies. Mild and temporary coughing up of blood can be treated by cough suppressants. However, if your coughing up of blood continues or worsens you should seek medical care.

Once the cause of coughing up blood is determined, your physician will talk with you about the best treatment plan that will address both your symptoms and the underlying condition. First, they may seek to stop the bleeding by embolizing (blocking) a bleeding artery or through a bronchoscopy.

Surgery and cancer treatment may be required if it is discovered your condition is caused by a tumor. Antibiotics may be prescribed for pneumonia or tuberculosis. Steroids may be used to treat inflammation causing the bleeding.

What should I do if I am coughing up blood?

Coughing up blood can be the sign of a serious medical condition.

If you're coughing up small amounts of blood for longer than a week, talk to your healthcare provider. They'll determine the cause of your hemoptysis.

Seek immediate attention if you are coughing up more than a few teaspoons of blood or your cough is accompanied by the following:

  • Chest pain.
  • Blood in your urine or stools.
  • Dizziness or light-headedness.
  • Shortness of breath.
  • Fever.
  • Rapid or severe weight loss.

Final Thoughts

So there you have it. Now you have a better understanding of hemoptysis and what it means when a patient is coughing up blood. You also now know how to respond as a Respiratory Therapist or other medical professional.

Thank you so much for reading and as always, breathe easy my friend.

Dr Rohit Bhaskar, Physio
Dr Rohit Bhaskar, Physio Dr. Rohit Bhaskar, Physio is Founder of Bhaskar Health and Physiotherapy and is also a consulting physiotherapist. He completed his Graduation in Physiotherapy from Uttar Pradesh University of Medical Sciences. His clinical interests are in Chest Physiotherapy, stroke rehab, parkinson’s and head injury rehab. Bhaskar Health is dedicated to readers, doctors, physiotherapists, nurses, paramedics, pharmacists and other healthcare professionals. Bhaskar Health audience is the reason I feel so passionate about this project, so thanks for reading and sharing Bhaskar Health.

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