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Haemoptysis (coughing up blood)

  What is haemoptysis?  

Haemoptysis refers to coughing up blood from the lungs or bronchial tubes (the tubes that bring air to your lungs).

It does not include having blood in your saliva due to bleeding in your mouth, upper airway or from vomiting of blood from your gut.

  Haemoptysis causes  

One of the most common causes of haemoptysis is an infection of the bronchi (the large tubes going down to your lungs), known as bronchitis. Another common cause is bronchiectasis, a disease where the large airways in your lungs are damaged.

Other causes of haemoptysis include:

  • chronic obstructive lung disease
  • lung cancer
  • tuberculosis
  • pulmonary embolism or a blood clot in the arteries that supply blood to your lungs
  • pneumonia or other lung infection
  • having something stuck in your airway
  • having fluid in your lungs due to a heart condition
  • being on anticoagulant therapy (blood-thinning medications)

Sometimes, doctors cannot find the cause.

  Haemoptysis diagnosis  

Haemoptysis is managed according to the amount and rate of bleeding and how sick you are. If your condition is life threatening, you may need urgent treatment before any investigations are done.

To find out the cause of your coughing up blood, your doctor will ask you questions about your cough. These may include the following:

  • How much blood are you coughing up?
  • How many times have you coughed up blood?
  • How long have you been coughing up blood for?
  • What other symptoms do you have?

You will probably be asked about your past and current medication and conditions, and whether you smoke.

Your doctor will check you for any signs of diseases that can cause you to cough up blood. They may take your temperature to check for an infection and look up your nose to make sure the bleeding is not from there.

Depending on your condition, you may be asked to have a chest x-ray or CT scan to detect any problems. You may also be asked to have a bronchoscopy, which is a procedure to see the inside of your airways and lungs.

If a blood clot in your lung is suspected, you may need a lung ventilation-perfusion scan, which looks at air flow and blood flow in the lungs.

Other tests that may be done include blood tests and a test to look for infection-causing bacteria in your saliva.

  Haemoptysis treatment  

The type of treatment you may receive will depend on the cause of your coughing up blood. For example, if a bacterial infection is the cause, you will probably be treated with antibiotics.

In severe haemoptysis, you may need a surgical procedure to stop the bleeding before the cause is found.