Haemoptysis is defined as coughing out of blood originating in the lower respiratory tracts that is trachea, bronchi and lungs. It includes coughing out of blood and blood streaked sputum. It is a symptom of a disease and not a disease. If the coughed up blood is more than 600-800 ml in 24 hours, urgent medical treatment may be needed.
What are the common causes?
The common causes for haemoptysis include infections of the lungs like tuberculosis, bronchitis, pneumonia, bronchiectasis or an abscess in the lungs. Cancer of the bronchi or lungs may also be present with haemoptysis. Other causes may be injury to the chest causing lung contusions. Irritation of the throat with violent coughing may also result in haemoptysis.
How is the condition diagnosed?
Detailed clinical history and physical examination of the chest and lungs is done to diagnose the underlying condition. The doctor may ask for diagnostic tests including X-ray of the chest, complete blood count, sputum culture, bronchoscopy, lung scan and lung biopsy. In bronchoscopy, a lighted tube is passed into the air passages that allows visualisation of the lining of the airways. Through this a biopsy of any suspicious area can also be taken.
What is the treatment?
Treatment may depend on the cause. Cough suppressants may be used in case of irritation of the throat from violent coughing but it is best to avoid them as they have the effect of allowing blood clot to accumulate in the bronchi. Haemoptysis usually stops spontaneously and nothing but reassurance is necessary. A sedative may be given to allay anxiety. If the underlying cause is infective, antibiotics may need to be given, sometimes even intravenously.
In case of severe blood loss, blood transfusion may be necessary. Control of bleeding by surgical measures is occasionally required. In this a portion of the lung or the whole diseased lung may have to be removed.