Hemoptysis, or simply the coughing of blood, is the expulsion of blood from the respiratory tract. The coughed up blood can either come from the throat (either the pharynx, larynx or trachea) or the lung itself. It may be due to a large variety of diseases, and fortunately, not all of them are serious conditions. The color and consistency can range from pink to bright red or frothy to combined with sputum, respectively.
There are many tests that can be done to determine the cause of hemoptysis and the extent of the damage. These include: chest x –ray and CT scan, lung biopsy and scan, sputum culture and smear, blood chemistry profile, coagulation tests, and bronchoscopy, among others.
It is not uncommon to produce blood-tinged sputum every now and then, thus it should not raise panic. However, if hemoptysis occurs often and/ or appears in large amounts, it may be best to seek medical attention, as it may be a serious case. Understanding hemoptysis can help when taking First Aid Courses.
Types of Hemoptysis
There are different types of hemoptysis, these include:
Blood-tinged sputum (very common)
- Usually appears in the form of streaks, spots or clots of blood in a whitish mucus or yellowish rancid sputum
- Generally harmless, unless it is caused by pneumonia, bronchitis or laryngitis
Coughing up pure blood (fairly common)
- Pure blood is coughed up without the mucus or sputum
- Generally caused by pulmonary tuberculosis, bronchial tuberculosis, bronchial hemorrhage or vascular rupture
Coughing up large amounts of blood
- May lead to severe bleeding if not treated immediately
- Generally caused by bronchial hemorrhage or vascular rupture
Pink frothy sputum
- Blood appears pink and frothy sputum
- The blending of the blood with the alveoli secretions gives its frothy appearance
- Generally caused by acute pulmonary edema or heart disease (which may result to acute heart failure)
Rusty sputum
- Blood appears as pigments in a reddish-brown sputum that resembles a prune juice in appearance
- May contain mucus, bacteria, slough necrotic lung tissues or all
- Generally caused by lobar pneumonia
Gelatinous blood sputum
- Blood appears as a brick red jelly-like substance present in a thick, bloody mucoid sputum
- Appearance is due to the mixing of the endobronchial plug of blood, bacteria, mucus and debris
- Generally caused by Klebsiella pneumonia
Causes of Hemoptysis
There is a wide range of conditions that may lead to hemoptysis. Apart from the ones mentioned in the previous subheading, the following conditions may also lead to hemoptysis:
- Lung tumor or lung cancer
- Pulmonary embolism
- Anticoagulation mechanisms
- Bronchiectasis
- Trauma to the lungs, such as stab wounds and gunshot wounds
- Cocaine use
Treatment for Hemoptysis
Treatment for hemoptysis will depend on the underlying cause. Treatment will usually include:
- Antibiotics (pneumonia and tuberculosis)
- Chemotherapy (cancer)
- Steroids (inflammatory conditions)
- Bronchial artery embolization
- Surgery (severe and life-threatening cases)
Hemoptysis is the coughing of blood from the respiratory tract, which may not always denote an underlying problem. Course of treatment for hemoptysis will depend on the cause.
