Hemoptysis is a frightening condition in which blood is periodically released along with sputum during coughing. In some cases, these are only bloody inclusions, while in others the blood completely stains the sputum. Based on the type and amount of blood impurities, one can roughly guess the source and cause of the bleeding, but delaying a visit to the doctor is unacceptable. In Anapa, the diagnosis and treatment of diseases that cause hemoptysis are dealt with in medicine.
What could be the reasons?
There are many reasons for coughing up blood. For example, traumatic damage to the trachea, pulmonary arteries or bronchi during tracheobronchoscopy. Various lung diseases can also be a source:
- Acute or chronic bronchitis
- Pneumonia
- Lung abscess
- Tuberculosis
- Pulmonary embolism
- Bronchiectasis
- Respiratory cystic fibrosis
- Lung cancer
Complex diagnostic methods
The examination begins with collecting an anamnesis - the doctor examines the patient’s complaints and asks him about the nature and frequency of hemoptysis. Based on these data, the specialist can already determine the area of the probable source of bleeding. For an accurate diagnosis and identification of the provoking disease, a comprehensive diagnosis is carried out.
- Blood tests. The scope of analysis is individual. The doctor may consider it necessary to find out your hemoglobin level and identify or rule out clotting disorders.
- Examination of sputum for the presence of bacteria, fungi, and atypical cells.
- A chest x-ray is always performed, since hemoptysis is most often caused by lung diseases. Fluorography shows tuberculosis, pneumonia, and other pathologies.
- Computed tomography gives a more accurate picture of the condition of the lungs. With its help, benign and malignant tumors and heart conditions are identified.
- Bronchoscopy is an endoscopic method of examining the inside of the trachea and bronchi to identify changes in the respiratory tract, neoplasms, and foreign bodies. This is the most informative method of establishing the cause of hemoptysis. The bronchoscope is inserted through the mouth or nose. If necessary, medical manipulations and surgical procedures are immediately performed.
- Biopsy - taking a sample of sputum or tissue for cytological or histological examination. The biopsy is performed during bronchoscopy. Helps to identify dangerous pathologies in the early stages, even if their signs are not detected on CT.
- ECG for the primary detection of heart disease. If there are suspicions, a more detailed examination is required.
If bleeding is suspected, call an ambulance. If hemoptysis is episodic, contact a diagnostic specialist. Here they will quickly establish a diagnosis and provide effective assistance.
How dangerous is this?
The danger of this condition depends on the cause. If blood in the sputum is present in the form of several “bloody streaks,” then most likely this is simply expectoration of capillaries that have weakened due to illness or excessive physical exertion. If this is the first and only case, there is no danger to health, but you still need to consult a doctor. If these are episodic or systematically recurring attacks with the release of sputum colored in shades of red or brown, this is a reason for immediate consultation with a qualified pulmonologist. A lot often depends on the promptness of diagnosis and initiation of treatment.
Main causes of hemoptysis
Hemoptysis is caused by diseases and neoplasms of the respiratory system, cardiovascular pathologies, gastrointestinal problems, foreign bodies in the respiratory system, and trauma.
Lung diseases lead to hemoptysis if tissue begins to disintegrate and blood vessels are damaged. The reason may be:
- pneumonia – inflammation of the lung tissue;
- bronchiectasis - dilation of the bronchi as a result of a purulent-inflammatory process;
- bronchitis – inflammation of the bronchial mucosa;
- vasculitis, which destroys the walls of blood vessels;
- tuberculosis;
- gangrene;
- bronchial fistulas;
- fungi and parasites;
- congenital malformations;
- chronic obstructive pulmonary disease.
A severe, prolonged cough due to respiratory tract infections can lead to rupture of small blood vessels in the laryngeal mucosa. In such cases there is little blood, it is released in patches. A small amount of bloody discharge is possible with sinusitis and frontal sinusitis.
Tuberculosis is accompanied by mucopurulent sputum with bloody inclusions of a bright red hue, alternating with the discharge of pure blood.
The type of sputum in pneumonia depends on the type:
- In case of croup - a sparse brown or brownish tint.
- With hemorrhagic it is bright red.
- During acute pneumonia, there may be a cough of pure blood or with impurities.
In case of malignant tumors in the lungs, raspberry sputum is coughed up. Hemoptysis is caused by bronchial adenoma, hemangioma, and other neoplasms.
Hemoptysis can be an alarming sign of diseases of the cardiovascular system . With mitral stenosis, blood with scarlet streaks. In the case of atherosclerotic cardiosclerosis, hypertension, myocardial infarction, at the beginning of a cough, scarlet sputum is released, turning into a more saturated bloody one.
Blood comes out with a cough when there is a stomach or duodenal ulcer. In women, hemoptysis may be a consequence of endometriosis - the proliferation of endometrial cells in the respiratory organs.
What should you tell your doctor?
Describe the discharge. How much blood is there in the mucus - is it a few drops, or is there blood with virtually no mucus? Is the blood pinkish and foamy, or is it an almost black clot? Is coughing up blood accompanied by pain in the throat or chest? Are you feeling nauseous, dizzy, or lightheaded? The doctor will definitely ask all these questions. The accuracy of the answers will directly affect the speed and accuracy of making the correct diagnosis.
If blood appears in your sputum, make an appointment with a pulmonologist. In case of an acute attack and illness, call us and immediately seek emergency medical help.
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Diagnosis of causes
A dangerous symptom can be caused by various reasons. The condition requires urgent examination. Various diagnostic methods will allow you to determine the factors that provoked the disorder. If you have hemoptysis, you should immediately consult a physician. Based on the results of the preliminary diagnosis, the patient will be referred to a specialist. For hemoptysis, the following diagnostic measures are prescribed:
- X-ray OGK. For a more detailed diagnosis, bronchial arteriography, bronchography, and angiopulmonography are prescribed.
- CT scan. The method is highly accurate. Additionally, MSCT of the lungs with intravenous contrast will allow you to evaluate the condition of the bronchial arteries and blood vessels.
- Fiberglass bronchoscopy. The method is used for endobronchial pathology. In addition to diagnostics, bronchoscopy allows you to remove a foreign body, collect sputum, cauterize an injured vessel, and remove an endobronchial neoplasm.
- Blood tests. The stage of anemia and the level of blood loss will be determined by a general blood test. A leukocyte test is prescribed for infection. A study to determine the gas composition and acid-base balance of the blood is prescribed for severe symptoms of respiratory failure.
- Analysis of bronchial secretions. Bloody sputum is examined to determine the presence of fungi, the causative agent of tuberculosis, helminth larvae, and atypical cells.
- Diagnostic operations. If all of the above methods did not allow us to identify the cause of the symptom, and there is information in the anamnesis about lung injury, or the bleeding increases, thoracoscopy or exploratory thoracotomy is performed.
- Heart study. An ECG is prescribed in the presence of cardiovascular pathologies.
Diagnostics makes it possible to differentiate hemoptysis from gastrointestinal bleeding. Heoptysis is characterized by scarlet-colored sputum. Hemoptysis does not occur during sleep. Blood from the respiratory tract comes out only when coughing. When bleeding occurs in the gastrointestinal tract, the blood becomes brown, has an unpleasant odor, and is released during vomiting.
Treatment methods depending on the cause
The doctor prescribes treatment tactics after conducting an examination and determining the cause of its occurrence. In most cases, a conservative method is used. In case of particularly severe pathologies, surgical intervention is resorted to. Drug therapy is aimed at eliminating the causes of hemoptysis, as well as normalizing the functioning of organs and preventing asphyxia. Conservative treatment includes:
- Antitussive drugs. Prescribed to relieve the cough reflex. Coughing attacks irritate and injure the bronchi, increasing the manifestation of the symptom.
- Plasma replacement. In case of large blood loss, plasma transfusion is prescribed to support the functioning of the body.
- Hemostatics. Hemostatic medications are prescribed to improve vascular permeability and normalize blood flow.
- Painkillers. Prescribed to relieve pain. In the final stages - narcotic drugs.
- Antibiotics. For tuberculosis and other pathologies caused by bacteria, antibacterial therapy is indicated.
- Chemotherapy. Prescribed for diagnosing oncology and other serious diseases with a high risk of relapse.
Medicines are prescribed only by a doctor after receiving the diagnostic results. Hemoptysis is only a symptom of pathology. Treatment tactics depend on the disease.
Who should I contact if I have hemoptysis? You must make an appointment with a therapist. The specialist will conduct an initial examination and provide a referral for consultation with a specialist.
Surgical treatment is used if drug therapy has failed or the condition is life-threatening. During surgery, the bleeding vessel is ligated. In especially severe cases, a part of the lung with a damaged vessel is removed.
4.Treatment
Obviously, the strategy and tactics of care are determined by the diagnosed (or most likely, taking into account clinical data) causes of bleeding.
It is not possible to list or describe at least the main options for conservative and/or surgical treatment. However, in all cases, the primary task is hemostasis (stopping bleeding), stabilization of basic vital signs (blood pressure, heart rate, respiratory rate), elimination of the root cause and/or relief of exacerbation of the underlying disease, blood replacement according to indications, decisive measures to prevent severe complications, the likelihood of which given these conditions circumstances is very high.
3. Symptoms and diagnosis
Pulmonary hemorrhage may appear suddenly or develop gradually from hemoptysis, but in any case it is accompanied by sallow pallor, cold hyperhidrosis, cyanotic discoloration of the skin of the extremities, a sharp decrease in blood pressure, tachycardia, tinnitus, dizziness, weakness, often anxious-panic disorganization of the psyche, disorders vision, convulsions, confusion with transition to deep fainting, stuporous state or agony.
Death usually occurs due to asphyxia and/or hypovolemic shock caused by rapid massive blood loss.
There is usually very little time left for diagnosis and taking emergency life-saving measures, and in such cases, much depends on the doctor’s ability to pay attention to the color of the blood, the nature of pulmonary wheezing, breathing patterns, heart murmurs, etc. An urgent consultation with a specialized specialist (gastroenterologist, parasitologist, oncologist, etc.) or instrumental examination (FEGDS, MRI, CT, radiography, bronchoscopy) is often necessary. Samples of biomaterial (sputum, blood, pus, etc.) are sent for laboratory biochemical, histological, microbiological analysis.
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Diagnostic methods in Medscan
Diagnosis for hemoptysis includes:
- Taking anamnesis - it is important to establish the history of the symptom and the presence of chronic diseases that could cause it.
- Physical examination - allows you to detect accompanying symptoms.
- Laboratory tests - Abnormalities in blood and urine values may be clinically significant.
- Computed tomography - in Medscan CT allows you to identify inflammatory processes, pulmonary neoplasms, determine their nature, stage of development and the presence of metastases.
- Bronchoscopy - this method makes it possible to assess the condition of the bronchi and take a sample of lung tissue for histological examination. Based on it, the doctor judges the presence of a tumor, its benignity or malignancy.
1.General information
First of all, a few general words should be said about those situations when a person sees his own blood outside the body. If this is a medical procedure (for example, blood sampling for clinical analysis), or a superficial scratch (which, however, must also be aseptically treated to avoid infection), or menstrual blood in women (without any deviations from the established cycle) - worry, Of course it's not worth it.
But any other appearance of blood, even in small or barely noticeable quantities (any signs of hemorrhage, bleeding ulcers, “leaking” effusion, etc.) is in all cases a serious situation, requiring consultation, examination and medical intervention, and often ( depending on a number of circumstances), assistance should be provided not just “in the near future,” but on an urgent or emergency basis.
This is especially true for massive blood impurities in urine, feces or expectorated sputum: such phenomena never arise “just like that” - this is a symptom, and in medicine it is considered one of the most formidable.
Coughing up blood, tasting or having blood in the mouth can have many different causes.
Some of them may not pose an immediate threat to life and health. But this is one of those cases when it is definitely better to make a mistake like a “false alarm” by visiting or calling doctors “in vain” than to waste precious time and bring the situation to a critical or irreversible point.
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