Hemoptysis or Bloody Sputum: Types, Symptoms, Complications, Diagnosis
What is Hemoptysis or Bloody Sputum?
Hemoptysis is the disease that causes blood in the sputum combined with cough. It is generated from the respiratory tract. In the disease of hemoptysis or bloody sputum, blood is ejected from the mouth, nose, air passages that leads to the lungs or the throat. Hemoptysis or bloody sputum would also originate from the lungs.
If the person is nonsmoker, mucous with tinged blood signify mild infection. Generally, ruptured blood vessel could be the reason for infection in the respiratory tract
In patients with a history of smoking and those who are otherwise at risk for lung disease, however, hemoptysis or bloody sputum is often a sign of serious illness. Smokers with history of lung infection can get affected by hemoptysis or bloody sputum.
Bronchiectasis along with pulmonary embolus is probably the cause of the occurrence of hemoptysis or bloody sputum. In addition, hemoptysis or bloody sputum is also caused by in ingestion of the foreign substance because some of them tend to damage the blood vessels. If you are suffering from hemoptysis or bloody sputum, it is important to contact the physician.
Hemoptysis or Bloody Sputum Vs. Pseudohemoptysis Vs. Hematemesis
If the blood is particularly ejected from the respiratory tract or from the nose or back of throat, the condition is called hemoptysis. Sometimes the blood may also originate from the gastrointestinal tract.
If the blood is coming from the areas which are outside of the respiratory tract then it is known as pseudohemoptysis.
Medical researchers define the condition of the blood vomiting as hematemesis. It is considered as a category of pseudohemoptysis. For diagnosis, it is vital to find the differences between hemoptysis and hematemesis.
What Does It Mean When you Cough up Blood?
Blood in the cough can occur due to infection as well as cancer. It is a serious and a life threatening situation for the patients. One should contact the doctor to diagnose the underlying issue except in cases where the correlation with bronchitis is already established.
What Can Cause Blood in Sputum?
Causes of hemoptysis or bloody sputum incorporates good pasture syndrome, lung cancer, mitral stenosis, chest trauma, pulmonary embolism, pulmonary edema, epistaxis, cystic fibrosis, hookworm parasites, bronchitis, tuberculosis, infection of the lung with pneumonia.
Facts about Hemoptysis or Bloody Sputum
- Blood in the sputum results due to the infection in the respiratory tract.
- An infection of the lower respiratory tract and inhalation of a foreign body are the most common causes of hemoptysis or bloody sputum in children.
- In kids the primary cause of infection is the inhalation of the foreign objects inside the lungs.
- Physicians should differentiate the symptoms of the hemoptysis or bloody sputum from the blood which is ejected while vomiting.
- Smoking can cause blood related sputum.
- Patients who are suffering from persistent cough should contact the doctor.
Types of Hemoptysis or Bloody Sputum
Hemoptysis or bloody sputum can be categorized into mild or acute but the process is tricky. One cannot say with trust that the amount of blood in the sputum signifies the seriousness of the disease. Severe cases can only be differentiated with the help of the doctors.
Mild Hemoptysis or Mild Bloody Sputum
Generally, if the blood is not in large amount, the condition can be classified as mild type of hemoptysis or bloody sputum. Majority of the cases are benign and the blood would not appear in the sputum after sometime.
Mild symptoms of hemoptysis or bloody sputum may cause breathing problems; therefore it is important to find the exact reasons of the bleeding. Hemoptysis or bloody sputum can occur abruptly however it is difficult to ascertain whether the symptoms can snowball into a major issue. Prior diagnosis is essential to eliminate the problem of hemoptysis or bloody sputum.
Massive Hemoptysis or Massive Bloody Sputum
If the amount of the blood is so large that it interferes with breathing, the condition of hemoptysis or bloody sputum is deemed as serious and calls for immediate attention. People suffering from acute cases of hemoptysis or bloody sputum can increase the mortality rate by many notches. It can increase up to 75%. Patients can die from lack of oxygen because of the deposition of blood in the respiratory tract.
Signs and Symptoms of Hemoptysis or Bloody Sputum
There are multiple signs and symptoms of hemoptysis or bloody sputum. There are different reasons for the occurrence ranging from bronchial infection which is mild to lung cancer. The occurrence of the traces of blood in the cough could point to various reasons. In addition, some of the signs and symptoms that would help to take correct decisions are as follows:
- Severe chest pain along with blood in sputum can be a symptom of hemoptysis.
- Breathlessness while exercising,
- Low grade Fever,
- Severe nausea,
- Breathing at a faster rate,
Upon occurrence of the blood in the sputum is the sign of danger and therefore it is vital to contact the doctor. Patients do not know the source of the origin of the blood. As far as hemoptysis or bloody sputum and hematemesis are concerned, there is a huge gulf between the prognosis and also treatment.
Signs and symptoms of hemoptysis incorporate:
- Severe cough.
- Intense red blood in sputum.
- Frothy appearance of the blood.
Signs and symptoms of hematemesis include:
- Patient with alcoholic habit or infected liver.
- Nausea followed by severe vomiting.
- Black blood with brown tinge.
- Coffee color of the blood.
- Extremely black stools.
Risk Factors for Hemoptysis or Bloody Sputum
There are different diseases that can increase the risk factors for hemoptysis or bloody sputum:
- Immune deficiency viruses are a factor of risk for hemoptysis or bloody sputum.
- Immunosuppressant causes the disease of hemoptysis or bloody sputum after persistent usage.
- Vulnerability to tuberculosis is a risk factor for hemoptysis or bloody sputum.
- Smoking may cause disease which could be reason for the occurrence of existence of the blood in sputum.
- Cancer and the genetic affinity in the patient towards clotting could be the possible risk factors.
Complications in Hemoptysis or Bloody Sputum
Blood loss is responsible for causing deficiency of oxygen or even shock in the patients and it is a major complication in hemoptysis or bloody sputum.
Massive Hemoptysis should be treated immediately or else it might cause the death of the patient. Even mild Hemoptysis could also indicate the start of the lung cancer. Bleeding due to the lung infection should be treated as fast as possible.
It is vital to contact the chest specialist if you are facing the issue of hemoptysis or bloody sputum.
Tests to Diagnose Hemoptysis or Bloody Sputum
The diagnosis process for hemoptysis or bloody sputum is conducted to rule out the instances of hematemesis along with pseudohemoptysis. Blood can originate not only from the mouth but also from the intestines.
Once the hemoptysis is detected, it is vital to find the underlying cause such as cancer to the respiratory tract and also bronchial tubes. Laboratory experiments along with X-ray should be conducted get to the roots of the problem.
CT scan can detect the presence of cancer in the blood. Vascular abnormality can be diagnosed with the help of pulmonary angiography.
Medical History to Diagnose Hemoptysis or Bloody Sputum
Medical history of the hemoptysis patient has to be diagnosed along with the symptoms. It would go a long way in finding whether the individual is suffering from hemoptysis or bloody sputum. Appearance of the blood is taken into account by the doctors to arrive at a conclusion.
Doctors can conduct interview of the patients to determine the extent of the infection. Smoking history and cancer are also taken into account while diagnosing the problem. Bronchitis along with tuberculosis could be the possible reasons for the occurrence of hemoptysis or bloody sputum. In case of mild hemoptysis or bloody sputum, the usual culprit is chronic bronchitis but if the disease is massive, tuberculosis could be the cause. Doctor should eliminate the probability of the occurrences of other diseases before honing on to hemoptysis or bloody sputum.
What does the blood look like: Variation in the appearance of the blood from the bronchial tubes can throw light on the symptoms. Sputum with blood is an indication of the pulmonary infection. If it does not contain puss, doctor would explore the possibility of tuberculosis. If puss is present in sputum it might point to the problem of lung abscess. Frothy appearance of the blood might also indicate pulmonary edema.
Pattern of bleeding: Patients suffering from bronchitis or even bronchiectasis can have the problem of bleeding in an intermittent manner. If it occurs regularly, the symptoms can be associated with catamenial hemoptysis.
Other symptoms: Symptoms associated with hemoptysis include sudden weight loss which might indicate the onset of cancer. Night sweating accompanied by fever is termed as TB.
Risk factors for causative conditions: Lung cancer is an extremely serious complication and tests should be conducted to examine the occurrence of bronchogenic carcinoma. Some of the risk factors are as follows:
- Gender: Male
- More than 40 years
- Chronic Hemoptysis
- Blood in the cough.
Bronchoscopy along with biopsy is used to detect the instance of blood cancer.
Factors apart from cancer have to be taken into account. They could be infections from various agents such as parasites or may be virus accompanied by bacteria.
Laboratory Tests to Diagnose Hemoptysis or Bloody Sputum
Laboratory tests are required for the diagnosis of hemoptysis or bloody sputum. Sputum is analyzed under the microscope to gage at the extent of infection. Some others test include blood count followed by coagulation profile and findings related to the presence of mycobacterium in the cough. Sputum culture is also done to find the other possible causes of infection. In addition urine analysis is also carried out in detail.
Chest X-Ray to Diagnose Hemoptysis or Bloody Sputum
X-ray scans the area in lungs along with heart as well as bones. Radiologist would help to explain the image in detail. In majority of mild cases, the X-ray is clear and does not should any infection. Bronchoscopy is the test that would help to find the reasons of bleeding.
CT Scan to Diagnose Hemoptysis or Bloody Sputum
CT scan is considered to be a non-invasive procedure which combines the power of X ray images along with computer. Chest CT is known to provide three dimensional images of the upper region of the body. Doctors advise CT when they are of the view that the patient is suffering from cancer. In addition chest CT can also detect the presence of bronchiectasis.
Fiberoptic Bronchoscopy (with or without biopsy) to Diagnose Hemoptysis or Bloody Sputum
In bronchoscopy for hemoptysis or bloody sputum, the tube is inserted into the mouth and into the respiratory tract. The doctor can analyze the cell tissues that are located in the lungs internally. Biopsy is conducted to find the traces of infection and also the occurrence of cancer. Whole process can take only 15 minutes or at the maximum of one hour.
Rigid Bronchoscopy to Diagnose Hemoptysis or Bloody Sputum
Rigid bronchoscopy for diagnosing hemoptysis or bloody sputum is now not popular as it is being replaced with fiberoptic technology. Some doctors use the above mentioned testing technique to diagnose massive hemoptysis. Optics along with suction channels plays an important role in the diagnosis of the disease. To start the process, the patient is administered anesthesia before proceeding ahead.
Pulmonary Angiography to Diagnose Hemoptysis or Bloody Sputum
In pulmonary angiography for hemoptysis or bloody sputum, radiopaque solution is injected into the blood vessel. As a result doctors can get impeccable images of the inside using X-ray. It is a useful technique to analyze the coronary arteries in detail. Doctors can also analyze the state of the lungs that are affected with hemoptysis or bloody sputum. The respiratory system can work efficiently only if it receives blood from pulmonary arteries.
Bronchial angiogram along with the pulmonary angiogram is used to detect the presence of bronchiectasis. It can also be used to diagnose any vascular abnormality.