ไอเป็นเลือด สาเหตุเกิดจากอะไร อันตรายแค่ไหน - Hemoptysis (Coughing Up Blood): Causes and Treatment

Hemoptysis (Coughing Up Blood)

Hemoptysis is coughing or spitting up blood and mucus from the lower respiratory tract, encompassing the airways and lungs.

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Coughing Up Blood

Hemoptysis (Coughing Up Blood) is coughing or spitting up blood and mucus from the lower respiratory tract, encompassing the airways and lungs.

Hemoptysis is distinct from hematemesis. Blood in hemoptysis typically looks frothy and is mixed with mucus. Hematemesis involves vomiting a significant volume of blood from upper gastrointestinal tract bleeding.

When to see a doctor?

  • Coughing up more than a few teaspoonfuls of blood.
  • Coughing up small amounts of blood for more than one week.
  • You have accompanying symptoms as follows:
    • Blood in urine or stools
    • Chest pain
    • Dizziness
    • Fever
    • Night sweats
    • Shortness of breath
    • Rapid weight loss

What causes coughing up blood?

Usually, the cause of hemoptysis is not severe and is readily treatable. However, hemoptysis can be a sign of lung cancer or severe infections. Excessive blood loss can be fatal and require emergency care.

Bronchitis, pneumonia, and tuberculosis are common infectious causes of hemoptysis.

Other causes are:

  • Bronchiectasis
  • Cystic fibrosis
  • Vasculitis
  • Cocaine use
  • Complications from lupus
  • Congestive heart failure
  • Lung vascular injury
  • Irritation caused by bronchoscopic biopsy
  • Anticoagulants
  • Excessive coughing
  • Pulmonary embolism
  • Chronic obstructive pulmonary disease (COPD)
  • Pulmonary aspiration
  • Lung cancer
  • Epistaxis, tonsil or gum bleeding entering the windpipe
  • Foreign body airway obstruction, particularly in children

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How is coughing up blood diagnosed?

  • Medical history and physical exam: Your doctor will ask about the amount, frequency, and duration of your hemoptysis, as well as health risk behaviors such as smoking.
  • A chest X-ray.
  • A computed tomography (CT) scan of your chest.
  • A bronchoscopy to ascertain the bleeding site.
  • A complete blood count (CBC) for signs of infection.
  • A sputum culture to differentiate the cause of the hemoptysis between virus and bacteria.
  • A coagulation test
  • Pulmonary arteriography.
  • A urinalysis to rule out other possible causes.

Your doctor will choose suitable diagnostic methods based on the suspected cause of your condition.

How is coughing up blood treated?

  • Antibiotics for pneumonia or tuberculosis.
  • Steroids to relieve the inflammation causing the symptoms.
  • Surgery and cancer treatment if a malignant tumor is a cause.

If your condition is severe, you will need ICU care to stem the bleeding before your doctor can diagnose and pinpoint the cause. Your doctor may perform a bronchoscopy to clear the airway of blood clots or angiography and embolization of the culprit artery causing the bleeding. Doctors may also prescribe tranexamic acid to stop the bleeding.

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公開済み 19 6 2024

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