Coughing up blood is a medical condition called as hemoptysis. In young individuals who are otherwise healthy, coughing up blood is usually due to minor ailments like bronchitis. However, in elderly people, especially those who are chronic smokers, hemoptysis may be a symptom of some serious pathology. Let us look at some of the most common causes of hemoptysis:
- Acute or chronic bronchitis: Irritation of the airways due to acute or chronic bronchitis may lead to persistent coughing. Prolonged bouts of coughing may be occasionally accompanied with small amounts of blood in the sputum. The condition is rarely life-threatening and usually subsided within a week.
- Nosebleed: There may be times when bleeding from the nose may trickle down into the throat. This blood may get mixed up with the saliva and come up while coughing.
- Bronchiectasis: It is a long term condition in which excessive mucus is produced in the airways. The condition is associated with vigorous bouts of coughing. The sputum may be streaked with blood at times.
The above mentioned conditions are usually not associated with any other symptom. However, hemoptysis should be taken seriously when it is accompanied with other symptoms like fever, chest pain, night sweats, shortness of breath even with normal levels of activity and weight loss. Coughing up blood for more than a week or if the amount of blood in cough is becoming progressively more or when such bouts occur off and on should also be taken seriously and one must meet the physician for further evaluation. Some of the more serious conditions which may lead to coughing up of blood include:
- Pulmonary tuberculosis: This is a severe lung infection commonly seen in developing countries and becoming increasingly common in UK.
- Lung cancer: If a chronic smoker above the age of 40 complains of persistent hemoptysis, one must seriously consider the possibility of lung cancer.
- Cancer of the bronchus: This can also present itself as hemoptysis.
- Pulmonary edema: This is a situation where there is fluid collection in the lungs and is usually a result of heart failure. The patient produces copious amounts of sputum which is frothy in nature and pink in color because of the presence of blood.
- Pulmonary embolism: Blood clot dislodged from elsewhere reaches the lungs and hinders the pulmonary circulation. The patient complains of sudden breathlessness and chest pain and coughs up a lot of blood. The condition can prove fatal.
Apart from the above mentioned causes, there are some rare causes of hemoptysis. They include mitral stenosis, a condition affecting the heart valves and polyarteritis nodosa, a rare disease affecting the blood vessels.
There are times when no reason can be found out behind coughing up blood.
However, as many a times, hemoptysis is a symptom of some serious underlying condition; the patient should be evaluated properly. Some of the steps involved in diagnosis include:
- A complete medical history and a thorough physical examination
- X-ray of the chest to identify any mass or fluid collection
- CT scan of the lungs to identify any pathology
- Bronchoscopy to identify any pathology in the airways.
- Complete blood picture including coagulation tests
- Urine examination
- Arterial blood gas analysis
- Pulse oximetry to find out the oxygen saturation of the blood.
With the help of these diagnostic tests, one is usually able to identify the cause behind coughing up of blood and appropriate treatment is started accordingly.
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