Summary about Disease
Haemoptysis is the coughing up of blood or blood-stained sputum from the lungs or airways. The amount of blood coughed up can range from a streak to a large volume. It is important to distinguish haemoptysis from pseudohemoptysis (blood originating from the upper respiratory tract or gastrointestinal tract) and hematemesis (vomiting of blood). The underlying causes of haemoptysis vary widely and can range from mild infections to serious conditions like lung cancer or pulmonary embolism.
Symptoms
Coughing up blood or blood-streaked sputum
Frothy sputum mixed with blood
Chest pain or discomfort
Shortness of breath
Lightheadedness or dizziness (if significant blood loss)
Fever (depending on the underlying cause)
Causes
Infections: Bronchitis, pneumonia, tuberculosis, fungal infections
Lung diseases: Bronchiectasis, chronic obstructive pulmonary disease (COPD), cystic fibrosis
Lung cancer: Tumors in the lungs or airways
Pulmonary embolism: Blood clot in the lungs
Trauma: Injury to the chest or lungs
Cardiovascular: Pulmonary edema, mitral stenosis
Autoimmune diseases: Granulomatosis with polyangiitis (Wegener's)
Medications: Anticoagulants
Idiopathic: Unknown cause
Medicine Used
4. Medicine used The medications used depend on the underlying cause of the haemoptysis. Some examples include:
Antibiotics: For bacterial infections like pneumonia or bronchitis
Antifungals: For fungal infections
Bronchodilators: For COPD or asthma-related causes
Corticosteroids: For inflammatory conditions
Antitussives: To suppress coughing (use with caution as coughing helps clear the airways)
Tranexamic acid: An antifibrinolytic drug that can help to reduce bleeding
In severe cases: Embolization (blocking the bleeding vessel) or surgery may be required.
Is Communicable
Whether haemoptysis is communicable depends on the underlying cause. If the cause is an infectious disease like tuberculosis or pneumonia, then the underlying disease is communicable. Haemoptysis itself is not directly communicable.
Precautions
Precautions depend on the underlying cause:
Infectious causes: Follow standard infection control measures (hand hygiene, respiratory etiquette, isolation if necessary). If TB is suspected, airborne precautions are necessary.
General precautions: Seek medical attention promptly if you experience haemoptysis. Avoid smoking and irritants that can worsen coughing. Follow your doctor's recommendations for managing any underlying medical conditions.
How long does an outbreak last?
There is no "outbreak" of haemoptysis itself. The duration of haemoptysis depends entirely on the underlying cause and how effectively it is treated. It can range from a single episode to chronic, recurring episodes. If the cause is an infection, the haemoptysis will typically resolve as the infection clears.
How is it diagnosed?
Medical history and physical exam: To assess symptoms and risk factors.
Chest X-ray: To visualize the lungs and airways.
CT scan of the chest: Provides more detailed images than an X-ray.
Bronchoscopy: A flexible tube with a camera is inserted into the airways to visualize the source of bleeding and obtain samples for testing.
Sputum culture and cytology: To identify infections or abnormal cells.
Blood tests: To assess overall health and look for signs of infection or other underlying conditions.
Pulmonary angiography: To identify bleeding vessels.
Timeline of Symptoms
The timeline of symptoms varies depending on the cause:
Acute infections (e.g., bronchitis): Haemoptysis may develop over a few days along with other symptoms like cough, fever, and chest congestion. It may resolve within 1-2 weeks with treatment.
Chronic conditions (e.g., bronchiectasis, COPD): Haemoptysis may be intermittent and recurrent, with episodes lasting for days or weeks.
Lung cancer: Haemoptysis may be a late-stage symptom and can be persistent or intermittent.
Pulmonary embolism: Haemoptysis may occur suddenly along with chest pain and shortness of breath.
Important Considerations
Severity: The amount of blood coughed up is an important factor in determining the urgency of medical evaluation. Massive haemoptysis (generally defined as >100-600 ml of blood in 24 hours) is a medical emergency.
Underlying health conditions: Individuals with pre-existing lung conditions, heart disease, or bleeding disorders are at higher risk of complications.
Age: Older adults are more likely to have serious underlying causes such as lung cancer.
Travel history: Travel to regions with endemic tuberculosis should raise suspicion for TB-related haemoptysis.
Smoking history: Smoking is a significant risk factor for many causes of haemoptysis, including lung cancer and COPD.