Frequently Asked Questions

Acute Hemoptysis

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What is acute hemoptysis?

Acute hemoptysis is sudden coughing or spitting up of blood. This occurs when blood vessels in your airway or lungs weaken or break, and begin to bleed. You may bleed in small or large amounts that appear in your sputum (spit).

What other signs and symptoms may occur with acute hemoptysis?

When blood collects in your airway and throat or you have increased blood loss, you may have the following:

  • Wet or noisy cough, or cough attacks

  • Hoarse voice

  • Chest pain and shortness of breath when you lie down or exercise

  • Bright red or foamy blood in your spit, and you taste metal

  • Nausea or vomiting

  • Cold or pale arms and legs

  • You feel tired, weak, or faint

  • Fever

  • Weight loss that you cannot explain

What causes acute hemoptysis?

The cause of hemoptysis may not be known. Ask your healthcare provider about these and other causes:

  • Infection: Bronchitis, pneumonia, and tuberculosis (TB) are the most common lung infections that cause acute hemoptysis. HIV and influenza may also cause hemoptysis.

  • Medical conditions: Lung cancer is the most common disease that can cause acute hemoptysis. Heart or lung disease and pulmonary (lung) artery bleeding are other medical conditions that may cause bleeding.

  • Trauma: Bleeding may occur from an injury to your throat or chest, or from the force when you vomit. You may also spit up blood if you choke on an object or cough too hard.

  • Medicine, cigarette smoking, or illegal drug use: Pain and anti-inflammatory medicines may cause acute hemoptysis if not taken as directed. Cigarette smoking, and the use of illegal drugs, such as cocaine or marijuana, may also cause bleeding.

How is acute hemoptysis diagnosed?

Acute hemoptysis may be hard to diagnose because there are many possible causes. Your healthcare provider will ask how much blood you have coughed up, or if you have choked on it. He may ask if it is dark brown or bright red. Tell your healthcare provider if you have any medical problems or if you had a recent injury. Tell him if you have traveled recently, or been exposed to chemicals or TB. You may need the following:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Sputum sample: Sputum (mucus from your lungs) is collected in a cup when you cough. The sample is sent to a lab to be tested for the germ that is causing your illness. It can also help your caregiver choose the best medicine to treat the infection.

  • X-ray: This is a picture of your lungs, heart, and the inside of your throat. Your healthcare provider will use it to locate the bleeding or to find signs of infection, such as pneumonia. X-rays may also show tumors, throat damage, or fluid around the lungs.

  • CT scan: This test is also called a CAT scan. An x-ray and computer will be used to take pictures of your throat and chest. You may be given dye before the test to help your healthcare provider see the details of your throat and lungs. Tell your healthcare provider if you are allergic to dye, iodine, or seafood. You may also be allergic to the dye.

  • Bronchoscopy: A long, bendable tube is placed into your airway and lungs to check for bleeding. Healthcare providers may also use the scope to collect fluid and cells to be sent to the lab for tests. Your healthcare provider will give you medicine to help you relax before this test. Your healthcare provider may also use the bronchoscope to stop the bleeding.

How is acute hemoptysis treated?

Ask your healthcare provider about these and other treatments you may need for acute hemoptysis:

  • Medicines:

    • Antibiotics: This medicine may be given to help fight or prevent an infection. Take your antibiotics until they are gone, even if the bleeding stops.

    • Antitussives: These medicines help control or stop your cough.

    • Vasoconstrictor agents: These are topical medicines used to constrict the blood vessels and slow or stop the bleeding.

  • Procedures:

    • Cold lavage: Cold saline (salt water) is used to rinse your nose and throat. The cold helps decrease or stop the bleeding.

    • Bronchial artery embolization: This is also called BAE. Medicine will be injected into your damaged blood vessel to help stop the bleeding.

    • Surgery: You may need surgery to help stop large bleeds if other treatments do not work. Surgery may also be done to look for and correct other problems with your airway.

What can I do to prevent or manage acute hemoptysis?

  • Do not take herbal medicines: Herbal supplements increase your risk of bleeding. Examples are garlic, gingko, and ginseng.

  • Do not smoke, and do not go to smoky areas: Smoke may worsen your hemoptysis. If you smoke, it is never too late to quit. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Stop smoking to improve your health and the health of those around you. If you smoke, ask for information about how to stop.

When should I follow up with my healthcare provider?

Follow up with your healthcare provider or lung specialist within 2 days or as directed. You may need frequent visits to monitor your condition and prevent further blood loss. Write down your questions so you remember to ask them during your visits.

When should I contact my healthcare provider?

  • You have new or increased shortness of breath.

  • You have a fever.

  • You lose weight without trying.

  • You feel more weak and tired than usual.

  • You have a cough that does not improve or gets worse.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have new or worse chest pain or shortness of breath.

  • Your bleeding gets worse or you cough a large amount of blood (more than 1 tablespoon).

  • You cannot stop vomiting.

  • You are so dizzy that you think you may fall or you faint.

  • You have pain or swelling in your legs.

  • Your legs and arms feel cold or look pale.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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