Hemoptysis refers to the symptom of coughing up blood or blood-mixed sputum, indicating bleeding from the lungs or bronchi. This article explains the definition, causes, diagnosis and treatment methods, and emergency response procedures based on official medical information. We recommend visiting a medical institution for accurate diagnosis, and note that policies or standards may change, so please check the latest information.
What is Hemoptysis
Hemoptysis is the condition of coughing up blood or blood-mixed sputum originating from the bronchi or lung parenchyma. It excludes nosebleeds or gastrointestinal bleeding (hematemesis), and the blood is typically bright red. Criteria for massive hemoptysis vary slightly by source.
Small amount hemoptysis appears as blood mixed in sputum, while massive hemoptysis is life-threatening. This symptom signals various respiratory diseases, making early response crucial.
Main Causes of Hemoptysis
Causes of hemoptysis exceed 100 types and vary widely in Korea, commonly including bronchitis, bronchiectasis, tuberculosis, and lung cancer. Tuberculosis was the main cause in the past, but lung cancer rates have recently increased. Bronchial artery bleeding accounts for over 90%.
Common causes include acute bronchitis or pneumonia, chronic bronchitis and bronchiectasis, tuberculosis and lung cancer, and other conditions like Behçet’s disease complications.
Causes differ by patient, requiring accurate differentiation. Diagnostic standards may vary with policy changes.
Hemoptysis Symptoms and Danger Signs
The main symptom is coughing up blood-mixed sputum, possibly accompanied by chest pain or shortness of breath. Massive hemoptysis presents with dyspnea, weakness, and rapid heartbeat. Fever, purulent sputum, or cyanosis suggests underlying disease.
Small amount hemoptysis involves minimal blood mixed in sputum and carries low to medium risk. Massive hemoptysis is an emergency situation requiring immediate intervention. Accompanying symptoms like chest pain, dyspnea, and fatigue indicate high risk.
Visit the emergency room immediately for danger signs such as massive bleeding, dyspnea, or cancer history. Persistent symptoms may require CT or additional tests.
Hemoptysis Diagnosis Methods
Diagnosis begins with history taking, physical exam, chest X-ray, and CT scan. Flexible bronchoscopy, HRCT, and bronchial angiography are used to identify the bleeding site and cause.
The process includes history taking to assess bleeding amount, rate, and accompanying symptoms; imaging tests like X-ray, CT, and endoscopy; and blood tests for coagulation abnormalities.
Diagnostic criteria may vary slightly by institution; follow the latest guidelines.
Hemoptysis Treatment and Management
Treatment varies by cause, with hemostatic and antitussive agents as basics. Massive hemoptysis involves intubation, mechanical ventilation, and bronchial artery embolization. Laser or cauterization is also possible.
Hemostatics like tranexamic acid are used for small to medium amounts and improve mortality rates. Vascular embolization treats persistent bleeding but has recurrence rates of 9.8-57.5% and requires kidney function monitoring. Surgery serves as root treatment for non-responsive cases.
Maintaining stability and suppressing cough is important. Regular check-ups are recommended due to recurrence risk. Support scope may vary by policy.
Frequently Asked Questions
Is small amount hemoptysis okay?
Even small amounts may indicate serious underlying disease, so visit a medical institution for accurate diagnosis. Repeated cases require ruling out lung cancer, etc.
How to respond to massive hemoptysis?
Go to the emergency room immediately, suppress coughing, and rest. Preserving a blood sample to show medical staff is helpful.
Possibility of tuberculosis as hemoptysis cause?
Common in Korea, but lung cancer rates have risen recently. Confirm via testing.
Preventing hemoptysis recurrence?
Treat underlying disease, quit smoking, and regular check-ups are key. Seek care promptly if symptoms recur.
Relation between smoking and hemoptysis?
Smoking increases lung cancer risk, raising hemoptysis likelihood. Utilize national cancer screening (low-dose CT).
Essential Checks Before Hemoptysis-Related Actions
Use official medical institutions or government health sites to verify hemoptysis information.
Check underlying disease and diagnostic criteria, which vary by individual; emergency response and treatment periods via latest guidelines; support eligibility for medical costs, which may vary by year or region; and recurrence risk and follow-up, depending on patient status.
Review latest standards matching your situation via public programs or official announcements. Prioritize expert consultation if uncertain.
Massive Hemoptysis Criteria Confirmation
Massive hemoptysis criteria vary slightly by institution. Seoul National University Hospital defines it as 100-600mL or more in 24 hours, comprising 1.5-5% of all hemoptysis cases. Asan Medical Center uses 100mL per hour or 600mL or more in 24 hours as emergency criteria.
Fatima Hospital also defines it as 100-600mL or more in 24 hours with high mortality. MSD Manual sets ≥600mL/24 hours for massive and ≥1L for asphyxiating cases as international standards. The Korean Respiratory Society guideline is 100mL or more in 24 hours.
Criteria may differ by individual case; confirm via official medical sites or during consultation. Seek specialist advice immediately if hemoptysis occurs.
Next Steps When Hemoptysis Occurs
If hemoptysis is suspected, visit a nearby medical institution immediately for diagnosis. Check latest treatment guidelines and support via official health sites. Responses vary by personal health; regularly monitor policy updates.