What is Hemoptysis (Coughing up Blood)?

Hemoptysis is a medical condition that refers to the expectoration of blood from the respiratory tract of an individual. Coughing up blood is a severe pulmonary disorder in which the source of blood is a ruptured bronchial artery caused by an infection in the bronchi or even lung cancer. If the source of blood is not the lungs or the respiratory tract, then it is termed pseudo-hemoptysis. However, if the bleeding sustains, you must get yourself tested at the earliest to avoid complications.

Depending on the amount of blood produced, it can be divided into – Mild (producing up to 20ml of blood), non-Massive (anywhere between 20 to 200ml of blood), or Massive (more than 100ml and up to 600ml of blood) Hemoptysis.

What are the Symptoms?

The primary symptom is bouts of incessant cough. In case of a wet cough, the mucus formed will contain bloodstains, turning it into pink or red. However, in dry cough, the individual will spit droplets of blood while coughing. This is often accompanied by chest pain, high fever, or  shortness of breath. As the condition aggravates, the amount of blood coughed out increases.

What Causes Hemoptysis?

Multiple reasons can cause a bloody cough. In most cases, it is due to a foreign particle in the airway that led to abrasion of the inner lining causing internal bleeding. However, this type of bleeding is very mild and should not last more than a few days.

In more severe conditions, the bleeding is caused by a ruptured blood vessel of the respiratory tract, mainly the bronchial artery, or due to  lung damage. This can happen due to one of these:

• Laryngitis – Inflammation of the larynx caused due to viral infection.
• Bronchitis – Inflammation of the bronchial tubes can affect the inner lining of these tubes.
• Lung Cancer – A condition developed in habitual smokers that causes accumulation of carcinogens that eventually damage the lungs.
• Tuberculosis – An infectious disease caused by Mycobacterium tuberculosis (MTB) bacteria that majorly impacts the lungs.
• Heart conditions – Cardiovascular conditions that result in pulmonary venous hypertension can cause cardiac haemoptysis. The most common of these is left ventricular systolic heart failure. Other cardiovascular causes include severe mitral stenosis and pulmonary embolism.

Other than these, conditions like embolism, parasitic infections, cancerous tumors, and autoimmune diseases can also damage the lungs. In addition to these, crack cocaine can also lead to bleeding in the respiratory tract.

When to see a doctor?

Coughing up blood is a serious medical condition and must not be overlooked. You must consult a doctor at the first sign and get yourself tested. Chances of controlling the bleeding and treating the underlying ailments get better if diagnosed at an early stage. When ignored, the condition can worsen, and excessive blood loss can prove fatal or permanently damage other vital organs and processes of the body. Some noticeable symptoms that one should look for are:

• Unexplained chest pain
• High-grade fever
• A persistent cough that lasts longer than eight weeks
• Shortness of breath while performing daily chores

As a practice, it is always advisable to keep a ready record of clinical, anatomical, and pathophysiological history that can help the doctor better diagnose the situation. 

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Treatment

Treatment for hemoptysis depends on the underlying cause of the same. It is suggested that you consult a doctor at the earliest to undergo tests and follow it up with suitable treatment. In some cases, it is required that you may undergo multiple tests, scans, and sampling to get to the root cause of the problem. Some commonly prescribed tests include blood tests, CT scans, X-rays, bronchoscopy, blood count, urinalysis, oximetry, and arterial blood gas tests .

In individuals with massive hemoptysis, the doctor will admit the patient to the intensive care unit (ICU) and start with intubation to ensure consistent oxygen availability. Later, depending on the situation, they will commence the treatment.

Hemoptysis: Preventive Measures

To ensure a better quality of life and healthy lungs, you must avoid smoking as it can severely damage the lungs in the long run. In addition, you must consume good quality, food items that are free from preservatives and other toxins. 

Conclusion

Coughing up blood is a sign of severe damage in the body and requires a thorough diagnosis to understand the underlying cause. In some cases, it can require interdisciplinary collaboration of various specialists to get to a conclusive diagnosis and subsequent treatment.

Frequently Asked Questions (FAQs)

Can some food particles cause blood in a cough?

In general, the food we consume does not cause damage to the respiratory tract that might lead to bleeding in the cough. However, if we consume food laced with preservatives and pesticides for a long duration, it does affect the overall immunity of the body. In addition, some of these pesticides enter the bloodstream and can cause damage to the lungs in the long run.

Will I die if there is blood in my cough?  

There is a possibility of mild bleeding while coughing in some viral infections, which can last for a few days. However, if the bleeding continues for long, there are chances of it being something serious. Your condition can worsen quickly and, if left unattended, can prove to be fatal in some cases.

Should I quit smoking?

Smoking tobacco regularly or being in proximity of regular smokers can have a major impact on the body. The harmful toxins settle in the lungs, slowly damaging the internal lining,  rendering them useless in the long run. Hence, it is advisable to not smoke in general, and in case you have been smoking in the past, you must stop it immediately if you notice even mild hemoptysis symptoms.