Pulmonary
- Critical Care Associates
of East Texas
Jeffrey M.
Shea, M.D., F.C.C.P.
Catherine M. Martinez, M.D.
|
Jeffrey M.
Shea, M.D., F.C.C.P. |
|
About
Our Practice
Patient
Information
Critical Care
Procedure Photos
Advanced Directives
BET
Program
What's New
|
What
is Hemoptysis? Also known as coughing up blood, it is a symptom of
bleeding somewhere in the respiratory tract.
Frothy and bright red blood may come from the nose, mouth, or throat
(upper respiratory tract), the lower respiratory tract, or the lungs.
The seriousness of the disorder depends on the cause of the bleeding. Hemoptysis from Upper Respiratory Tract The most common and least serious reason for blood in
the sputum is that coughing has ruptured a small blood vessel in the nose,
mouth, or throat. Infection or
damage in the mouth, throat, or back of the nose may also cause bleeding. Differential Diagnosis of Hemoptysis of Lower
Respiratory Passages Airways Disease ·
Acute or
chronic bronchitis ·
Certain
bronchial tumors (growths) Airway disease is the most common cause with the
bronchitis, bronchiectasis and bronchogenic carcinoma being the top causes of
hemoptysis. Bronchial carcinoid is
less common, but it also originates in the airways. Parenchymal
Disease ·
Tuberculosis ·
Lung
abscess ·
Pneumonia ·
Mycetoma
(fungus ball) ·
Goodpasture’s
syndrome ·
Idiopathic
pulmonary hemosiderosis These causes of hemoptysis are frequently infections.
Goodpasture’s and Idiopathic pulmonary hemosiderosis are rare. Vascular
Disease ·
Increased
pressure in the blood vessels of the lungs
Left ventricle failure (Heart failure)
Mitral stenosis · Vascular malformation Hemoptysis related vascular lesions are problems with the circulation through the lungs. Pulmonary embolism (obstruction of a pulmonary artery or one of its branches) causes elevated pressures in the pulmonary arteries and can cause death of the lung tissue. Pulmonary edema can cause frothy pink or red-tinged sputum. Pulmonary venous pressure can be elevated with mitral stenosis (narrowed (diseased) heart valve). Diagnosing the cause of Hemoptysis Patients should notify their doctor immediately if they are coughing up blood. The doctor will want to perform a thorough exam and review medications that the patient is on to determine if any may cause bleeding. Obtain a chest x-ray and or a CAT Scan, and lab work. A bronchoscopy may also be done to see where the bleeding is coming from. The physician is able to view the airways of the lungs during this procedure and obtain biopsies and cultures. Treatment
of Hemoptysis The natural history of hemoptysis is that it will cease temporarily. THIS DOES NOT DECREASE THE SUSPICION THAT A POSSIBLE LIFE THREATENING PROCESS MAY BE PRESENT which still requires a complete evaluation. In certain
circumstances where hemoptysis does not stop, this becomes a life threatening
problem. The main treatment is aimed at maintaining adequate oxygenation.
The definitive treatment is determined by the underlying cause. Medication
may be used to treat infections, such as pneumonia, tuberculosis, or bronchitis.
If lung cancer is present then appropriate treatment is pursued.
In extreme cases where hemoptysis does not resolve, therapeutic
bronchoscopy to stop the bleeding, occlusion of the bronchus by endobronchial
balloon catheters, or placing arterial coils into the artery supplying the
bleeding site can be done. Ultimately,
surgery may be done to remove the bleeding site. |
|
