Under Coughing up blood, Hemoptysis or Hemoptysis one understands the coughing up of blood, which under certain circumstances can also be mixed with mucus. The causes for this are various respiratory and lung diseases.
What is coughing up blood?
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Coughing up blood is not a disease in itself, but is a symptom of various diseases. A so-called sputum (slimy sputum) or just blood is coughed up, which either comes from the airways or the lungs.
Usually it is venous, very rarely also arterial. If the sputum is frothy and bubbly, it is arterial blood. A doctor should be consulted immediately with this form of coughing up blood.
Haemoptosis must be distinguished from diseases such as nosebleeds, bleeding from the stomach or esophagus or tooth injuries, in which blood is also eliminated from the mouth.
causes
The causes of coughing up blood are different. Hemoptysis can occur as part of tuberculosis, a disease that is very rare in Western countries.
Another possibility is pulmonary embolism, which is when the blood vessels in the lungs become blocked. In most cases, this blockage is due to a thrombosis in the pelvis or legs. The platelets bind together, causing a blood clot to appear that loosens and clogs the blood vessels.
Coughing up blood also occurs in cases of lung cancer, a ruptured lung or the infectious disease legionellosis. This is where the blood vessels in the lungs become damaged as physical pressure is applied to the walls of the blood vessels and blood leaks out. Occasionally, an abscess or acute pulmonary congestion can also cause blood to be coughed up. Another cause is bronchiectasis, a disease in which the bronchi become enlarged in the form of small pockets.
These fill with pus, cause bronchial wall infection, and the tissue dies. Some forms of coughing up blood can also be inherited, such as Osler's syndrome, in which small lumps form on the internal organs and mucous membranes. Lung bleeding and coughing up blood also occur in Ceelen-Gellerstedt syndrome, which is also a hereditary disease.
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➔ Medicines against coughs and coldsDiseases with this symptom
- Pulmonary hypertension
- Lung abscess
- Pulmonary embolism
- Lung cancer
- Ruptured lung
- Legionnaires
- Lupus
- Goodpasture Syndrome
- Cor pulmonale
- lung infection
- Pleural effusion
- Osler's disease
- Increased tendency to bleed
- Vascular malformation
- Ceelen-Gellerstedt syndrome
- Foreign body aspiration
- Bronchiectasis
- tuberculosis
Diagnosis & course
The diagnosis of coughing up blood depends on the cause. Therefore, the doctor will first look for the direct or indirect causes of hemoptysis. As part of the anamnesis, the doctor also asks when the coughing up of the blood has existed or under what circumstances the cough occurs.
Existing accompanying complaints or previous illnesses are also important. The doctor also pays particular attention to blood pressure and heart rate. In addition, the sputum is carefully analyzed and the airways are thoroughly examined. A close examination of the sputum is very helpful for further diagnosis. In the case of a true hemoptysis, for example, the sputum is bright red, while bleeding from the stomach has a black consistency.
It is also very important that the lungs are monitored, as this will allow the doctor to localize the bleeding. Since it is usually not possible to determine immediately whether the blood is coming from the gastrointestinal tract or the respiratory tract, it is important to check both options. In addition, a blood count is taken to identify any infections, anemia or tumor markers.
The source of hemoptysis can also be determined with the help of a bronchoscopy or an X-ray examination. An X-ray examination often provides very important information, as the image shows typical changes that occur in tuberculosis, a lung abscess or pneumonia.
With the help of a computed tomography, the chest can also be displayed very precisely and it is possible to find even small disease processes in the bronchi or lungs. A bronchoscopy is also used to locate the source of the bleeding. In addition, as part of this examination, the patient can also be given medication to stop the coughing up blood.
Complications
Regardless of whether it is haemoptysis (coughing up small amounts of blood) or haemoptosis (coughing up large amounts of blood), the complications are always serious.
If the cause of a coughing up blood is not treated, it can lead to shortness of breath, hemorrhage, or shock. Retrosternal pain and nausea are also known complications. In rather rare cases, a benign or slightly malignant bronchial carcinoid can develop. This carcinoid originates in the bronchial mucosa and is more likely to be seen in men and women at a younger age.
Lung metastases can also occur as a result of coughing up blood if treatment is not received. These are daughter tumors from other types of cancer. For example kidney, colon or breast cancer. It can be assumed that the primary tumor is at an advanced stage.
It is also known that lung cancer forms when coughing up blood. This is a malignant tumor of the bronchial mucosa. The tissue structure of a carcinoma and the tumor stage at the time of diagnosis form the basis for a prognosis. Pleural effusion (accumulation of fluid with blood, lymph and / or other components between the lungs and sternum) can also occur as a complication of a coughing up blood.
Coughing up blood can be associated with increased pressure in the blood vessels in the lungs. The result may be necrosis (tissue death). If an incipient coughing up blood is not treated, the blood vessel wall in the pulmonary vessels can tear if not treated.
When should you go to the doctor?
Coughing up blood occurs in various diseases of the lungs and airways. In hemoptysis, the medical term for coughing up blood, the blood is coughed up either pure or with mucus. The blood from the respiratory tract or lungs is mostly venous - darker in color, rarely arterial - lighter in color and then frothy and bubbly.
If the blood is of arterial origin, a doctor must be consulted immediately, preferably an emergency doctor. But coughing up blood from venous blood also requires urgent medical clarification.
Various diseases such as tuberculosis, legionellosis, pulmonary embolism, ruptured lung and bronchiectasis are possible causes of coughing up blood. The hereditary diseases Osler syndrome and Ceelen-Gellerstedt syndrome can also trigger coughing up blood. It is best for people who have coughed up blood to consult their family doctor first.
He will conduct an extensive medical history survey. It is to be expected that he will call in other specialists: radiologists, pulmonologists or oncologists. It can also be useful to consult a gastroenterologist, since when coughing up blood it is often not clear at the beginning whether the coughed up blood actually comes from the lungs or the respiratory tract or not from the upper gastrointestinal tract. Computed tomography often provides informative results when examining the blood cough.
Doctors & therapists in your area
Treatment & Therapy
The disease is then treated depending on the cause of the coughing up blood. Antibiotics are given for inflammation or infection, and chemotherapy or radiation therapy is used for lung cancer.
If the cause of the coughing up blood is a hereditary disease, treatment options are relatively limited. For example, Gellerstedt syndrome, which occurs at a young age, cannot be effectively treated to this day, and many sufferers die within twelve years of the occurrence of hemoptysis.
Outlook & forecast
Coughing up blood should always be treated by a doctor. If the symptom is not treated, it may cause shortness of breath from swallowing blood. As a rule, patients also complain of nausea or headaches. The loss of blood also increases the dizziness.
It is not uncommon for the causes of coughing up blood to be caused by cancer. In these cases, no general forecast can be made. The treatment takes place here with chemotherapy or surgical interventions and, if detected early, can lead to success and completely combat the problem.
If the coughing up blood is caused by inflammation or infection, antibiotics can be used. These usually lead to a positive course of the disease after about a week. The patient has no further complaints or problems after the illness. It is not uncommon for those affected to have a panic attack from coughing up blood, as blood is often linked to a serious illness. Going to the doctor gives you certainty.
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➔ Medicines against coughs and coldsprevention
Since coughing up blood is only a symptom of an illness, preventive measures are relatively difficult. A pretty good prevention is possible for thrombosis, here regular exercise and the avoidance of long sitting times help to reduce the formation of blood clots. A healthy diet and reducing or avoiding nicotine consumption are also highly recommended.
You can do that yourself
Coughing up blood (hemoptysis) should not be underestimated as a severe symptom of various clinical pictures in the area of the respiratory tract and other organs. Pure treatment on one's own initiative can be categorically excluded here. Especially if the patient is a child, the parents should present the child to the pediatrician on the same day.
Unlike a common cough, hemoptysis cannot be relieved with drugs such as cough suppressants or similar agents. The bloody sputum is extremely worrying and the person affected should go straight to the emergency room or to the doctor, because only there can the cause of the coughing up blood be determined. Since a large number of highly contagious diseases such as pneumonia or tuberculosis are associated with hemoptysis, it is important not to wait unnecessarily. It is advisable to take a sample of the sputum with you so that it can be examined. If the coughing up blood is accompanied by severe breathing difficulties, the emergency doctor must be called immediately.
However, if the person affected has already received a diagnosis that includes possible coughing up blood (e.g. lung cancer), it is sufficient to inform the treating doctor and, on his recommendation, to go into inpatient care. Depending on the cause of the coughing up blood, the doctor can quickly fight it or at least reduce it. Those affected who do not seek medical treatment, on the other hand, may risk their lives.
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