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From foreign bodies to lung cancer: What factors may cause coughing up blood?
Hemoptysis, or blood in sputum, can be a warning sign of many diseases. When a person passes blood or bloody sputum from the bronchi, throat, trachea, or lungs, whether accompanied by a cough or not, this is cause for concern. Coughing up blood may be related to infections such as lung cancer, tuberculosis, chronic bronchitis or pneumonia, and may also be related to certain cardiovascular diseases. In severe cases, if the amount of blood coughed up exceeds 300 ml, the patient may face fatal consequences.
Hemoptysis can be considered an airway bleed, even if coughing is not involved.
Diagnostic Methods
For the diagnosis of hemoptysis, medical history is key. The doctor will take a detailed medical history, including past medical history, current symptoms and family history, especially whether there is a history of tuberculosis, bronchiectasis, chronic bronchitis and heart disease.
During the clinical evaluation, doctors also consider the following:
- Duration, frequency and amount of blood
- The color and characteristics of the discharged blood, including fresh blood, foamy blood, etc.
- Accompanying symptoms such as fever, chest pain, cough, etc.
Clinically, the amount of hemoptysis and the accompanying symptoms can help doctors regulate the possible causes.
Differential Diagnosis
In adults, the most common cause of coughing up blood is a chest infection, such as bronchitis or pneumonia. In children, aspiration of foreign objects is often the main cause of hemoptysis. Lung cancer and tuberculosis are also common causes.
Other less common causes include:
- Fungal infections such as aspergillosis
- Heart disease, such as congestive heart failure
- Autoimmune diseases and certain rare conditions, such as Good Shepherd Syndrome
When the amount of coughed-up blood exceeds 200 ml, it can be defined as "massive hemoptysis", and its mortality rate may be as high as 80%. However, according to a report by Kinoshita et al., the mortality rate of hospitalized patients was approximately 9.4%. For life-threatening hemoptysis, the danger comes from suffocation, and levels below this range are usually not fatal.
For large amounts of hemoptysis, the medical community generally believes that special attention should be paid if the amount exceeds 200 ml.
Treatment Options
Treatment for coughing up blood will vary depending on the cause. Some of the main treatment options include:
- Use ice saline and topical decongestants such as epinephrine or vasopressin
- Laser therapy for hemostasis during bronchoscopy
- Selective bronchial intubation to control bleeding lungs
Of course, for some patients, surgery may be the last option, which may involve removing a lobe or the entire lung.
ConclusionCoughing up blood is a warning signal from the body and should be taken seriously. At the same time, we should also expand our understanding of the causes of coughing up blood, from common cases to other possible major diseases, and analyze the hidden dangers behind them. So, when faced with coughing up blood, how do you think we should accurately identify the underlying cause to ensure timely and effective treatment?
