Sputum with blood: cough, hemoptysis causes, coughing, streaks from the throat (nasopharynx), bronchitis, why when coughing in the morning, what to do

Category: What to do - how to do it right

Hemoptysis - bloody sputum

The medical term hemoptysis means coughing up sputum containing blood. Sputum (mucus) in the human body acts as a natural filter, even with moderate inflammatory respiratory pathologies; in principle, there should not be any additional inclusions in it.

The manifestation of hemoptisis is a symptom of serious problems that require urgent solutions and a potential threat to life. Don’t let the problem take its course, hoping that “it will go away on its own” - especially if you recognize the symptoms described below.

Causes of blood in sputum

The causes of sputum with blood are conventionally divided into several groups:

• Non-threatening;
• Congenital genesis;
• Common pathologies (abscesses, inflammatory processes, heart attack and tumor formations, pulmonary tuberculosis, bronchitis, fungal diseases, cardiovascular pathologies);
• Rare diseases.

The group that does not pose a threat includes: small vascular ruptures in the bronchi, the manifestation of hemoptysis due to heavy loads, diseases accompanied by a strong hysterical cough, mental injuries and taking blood thinning drugs.

In such cases, the mucus may contain a small amount or small blood clots, brown streaks, giving the sputum a rusty color. Such symptoms do not pose a threat and do not require treatment, as they soon go away on their own.

Features of the treatment of hemoptysis

Basic principles of therapeutic tactics for pulmonary hemorrhage:

As a rule, hemoptysis is not profuse and stops on its own without special therapy. It is necessary to reduce the conversation with the patient to a minimum and give him an elevated, semi-sitting position or a lying position on the sore side to prevent blood from entering the other lung. Swallowing small pieces of ice helps reduce symptoms of the disease. Bleeding, especially when it occurs for the first time, usually frightens the patient and others, so you need to reassure the patient if possible

However, sedatives are used with great caution because they can reduce protective reflexes and mask increasing respiratory failure; Tranquilizers that have a muscle relaxant effect (including on the diaphragm) are especially dangerous.

After emergency care is provided, the patient is subject to mandatory hospitalization. Transportation should be carried out on a stretcher with a raised head end on an ambulance in the presence of a doctor or paramedic. Only in a hospital setting is it possible to carry out the entire range of treatment measures aimed at stopping pulmonary hemorrhage, and a more detailed examination to determine its cause. In particular, patients need urgent consultation with a pulmonary surgeon, since cavernous tuberculosis, anaerobic abscess and lung cancer are indications for surgical treatment. If it is known that the patient suffers from tuberculosis, in case of hemoptysis he should be sent not to general hospitals, but to specialized anti-tuberculosis institutions.

The main goal of drug treatment is to suppress the cough that occurs, which can aggravate the severity of the patient's condition. For this purpose, codeine is used in a hospital setting, which is prescribed orally; in case of persistent painful cough and profuse pulmonary bleeding, 0.5 - 1 ml of a 2% Promedol solution is administered intravenously or subcutaneously as emergency treatment (narcotic analgesics effectively suppress the cough center). However, opiates should not be abused, since complete suppression of the cough reflex can lead to aspiration of spilled blood and the development of severe aspiration pneumonia.

In case of profuse, life-threatening pulmonary hemorrhage, not associated with pulmonary embolism or other cardiovascular pathology, hemostatic therapy is carried out in the hospital. Antifibrinolytic agents for the treatment of hemoptysis may be effective in the presence of a local increase in fibrinolysis: Aminocaproic acid is administered intravenously - up to 100 ml of a 5% solution over 30 minutes and then repeat the infusion every 4 hours until the bleeding stops; tranexamic acid – intravenously or intramuscularly in a dose of 5–10 ml (1–2 ampoules) of a 5% solution; In addition, transfusion of fresh frozen plasma is effective.

In case of massive hemoptysis and the appearance of symptoms of hypovolemia, colloidal (for example, 400 ml of Polyglyukin) or saline solutions are administered intravenously to replenish the volume of circulating blood (they, however, may need 4 times more volume than colloidal ones).

Hemoptysis - sputum with blood and temperature

High temperatures, cough and bloody sputum accompanied by shortness of breath and chest pain are a typical symptom of pneumonia after the flu, the development of a pulmonary abscess or tuberculosis.

Pneumonia can develop a week after influenza infection. The nature of the disease is mixed - viral and bacterial. Manifests:

• Pyretic temperature – over 39°C;
• Intoxication signs;
• Shortness of breath and severe pain in the chest;
• Attacks of exhausting cough with blood and purulent exudate in mucus.

Patients with weakened immune systems are susceptible to the development of cavities with purulent exudate in the lung tissue. Signs of the disease are due to:

• pain syndrome in the sternum;
• long temperature period;
• attacks of nocturnal hyperhidrosis (sweating);
• general malaise;
• insomnia (insomnia) and apathy to food;
• a large amount of coughed up mucus with pus and blood streaks.

With tuberculosis, the temperature is insignificant and does not exceed low-grade fever. The disease occurs with rapid weight loss and a constant cough with the presence of blood in the sputum, during expectoration, in the form of streaks and characteristic purulent inclusions.

During the thermal stage of tuberculosis, fresh blood in the mucus discharge can appear in large quantities.

Coughing with blood and fever is also characteristic of acute forms of bronchitis and bronchiectasis. Symptoms are manifested by bloody streaks in the sputum, sometimes with the inclusion of pus, accompanied by fever, weakness and suffocation.

Pathologies of the lower respiratory tract - the cause of hemoptysis

If the patient notices blood released when coughing, this may indicate pathological conditions of the bronchi and trachea.

Bronchitis is an infectious and inflammatory disease characterized by swelling and irritation of the bronchi, which may result in coughing up blood. The cause of a cough that bothers the patient for a long time is damage to the mucous membranes of the bronchial tree.

The disease is accompanied by the following clinical picture:

SENSATION! Follow the link:

4 groups of reasons for coughing up blood from the throat

• body temperature is increased;
• pain is felt in the chest area;
• exhausts general malaise and weakness.

In elderly people, the disease can occur without fever. A cough always accompanies this disease, and at first it is usually dry. Then it becomes productive, and sputum with mucus and pus begins to be coughed up. Coughing up blood during bronchitis indicates a deterioration in the patient's condition, which means that you should immediately seek medical help.

Bronchiectasis is irreversible pathological changes in the bronchi. The main symptom of this disease is a persistent cough. At the same time, a significant amount of purulent sputum is coughed up. If there is a severe form of the pathology, a constant expectorant cough can lead not only to rupture of small vessels and hemoptysis, but even to pulmonary hemorrhage if damage to large arteries occurs.

The patient has:

• signs of intoxication;
• anemia, exhaustion;
• respiratory failure.

Exacerbations occur in the form of infectious diseases of the respiratory system with an increase in temperature.

Bronchial tumors are benign or malignant neoplasms growing in the lumen of the bronchi or along their walls.

If the patient is bothered by a strong cough and coughing up blood, the reasons are associated with significant blockage of the lumen of the respiratory tract by the tumor. Persons suffering from chronic bronchitis, tuberculosis, and pneumoconiosis are susceptible to the occurrence of such neoplasms. Often the pathology is a consequence of constant smoking.

Sputum with blood without coughing, what is it?

Sputum with blood photo
With this symptom, in almost 10% of patients, the diagnosis does not always “work” even with a thorough and lengthy examination, which forces the patient to repeat the research process after two weeks.

And almost half of the patients who failed to establish a diagnosis turned out to be “ardent smokers.” Hemoptysis without signs of cough can occur for completely trivial reasons related to dental problems.

• Dental pathologies or gum injuries can cause bleeding. Mixing blood with saliva is often mistaken for pathological inclusions in mucus.

Such symptoms are also caused by recent hemorrhages in the nasal cavity, penetrating into the oral cavity, and expectorating with sputum for several days.

Such symptoms are typical for vascular tear of the aorta, as well as during medical procedures; such procedures provoke minor hemorrhage and do not require treatment.

But there are situations when hemoptysis without cough can be a consequence of internal pathologies. The cause may be infectious processes in the respiratory system, a blood clot in the lung, oncological pathology, or problems with hemostasis (blood clotting). Indicate the presence of problems with the heart and blood vessels.

The most common cause is cardiogenic pulmonary edema, manifested by weakness and pain in the chest area, and a slight discharge of bright scarlet foamy sputum. Cases of mortality are common. In any such case, a qualified examination is necessary.

Quick help for hemoptysis

In case of severe and sharply progressive hemoptysis, the patient, first of all, should quickly provide first aid in order to avoid significant blood loss and complications.

1. First of all, the patient is placed in a sitting position on the floor.
2. A tray with ice cubes is placed within reach, and the patient is asked to swallow them at intervals of several minutes.
3. The patient is provided with plenty of fluids: cool, still water and iced tea are given to drink.
4. Emergency care is urgently called and the patient is hospitalized in a hospital, where he is provided with subsequent care.

In a hospital setting, doctors provide emergency treatment aimed at eliminating the symptoms of bleeding and impending blood loss.

Symptomatic therapy is aimed at relieving pain spasms and reducing the intensity of cough

Doctors approach the suppression of pronounced cough spasm during hemoptysis with caution, since cough suppression can provoke stagnation of blood in the bronchopulmonary system and, as a result, a complicated course of aspiration pneumonia. For a painful and debilitating cough, the patient is prescribed a number of medications that can relieve strong urges and spasms. Initially, doctors give the patient oral dosage forms; if such treatment is ineffective, they prescribe injections of potent drugs.

The simultaneous administration of dosage forms and drugs that help stop bleeding is also effective. In the event that a quick symptomatic effect does not give the desired effect, the doctor decides on a blood transfusion procedure in order to prevent complications due to blood loss.

In the context of emergency care for hemoptysis, immediate antimicrobial therapy is practiced in order to prevent suppuration and subsequent formation of an abscess in the lungs. Rapid antibiotic therapy is also designed to effectively stop the inflammatory pulmonary process and destroy microbes that provoke hemoptysis.

Why is there blood in my sputum in the morning?

The manifestation of hemoptisis in the morning often indicates long-term functional disorders in the body associated with:

• With inflammatory or tumor processes in the lung tissue;
• The development of cellular allergies and granulomas of a specific nature in various organs and systems of the body caused by tuberculosis bacteria;
• Hemorrhagic diathesis;
• Vascular aneurysm or varicose veins;
• Pathologies of the nasopharynx and tonsils.

To clarify the diagnosis, a thorough comprehensive examination is necessary.

Diagnostics

Diagnosis of pulmonary hemorrhage itself is carried out by external examination - if the patient is bleeding from the mouth, the doctor will determine the development of pulmonary hemorrhage based on the totality of symptoms and the appearance of the blood being released. And to identify the causes of bleeding, an examination and opinion of several doctors of various specialties is usually required. To select treatment methods for this condition, it is necessary to accurately determine the background of what disease caused the bleeding. Specialists study the history of the disease and turn to laboratory and instrumental diagnostic methods.

For a correct diagnosis, it is important for the doctor to provide as detailed information as possible: how long ago the bleeding began (including hemoptysis), how much blood is released, whether this happened for the first time or the bleeding is repeated, and if repeated, then how long ago the first case was recorded.

The doctor also finds out what diseases the patient has been diagnosed with, whether there is a risk of developing hereditary diseases (for example, cardiovascular diseases) and occupational diseases (associated with working in hazardous production conditions).

Laboratory tests include a clinical blood test and sputum examination. Test data will help the doctor identify a disease that is complicated by bleeding, as well as assess the level of blood loss using a number of clinical indicators. Based on the bacteria and tissue microparticles contained in sputum, a specialist can distinguish tuberculosis, oncology or other diseases.

The main assistants in diagnosing the disease are instrumental methods:

• x-ray of the lungs in two projections;
• ultrasonography;
• MRI or CT;
• bronchography, bronchial arteriography, angiopulmonography.

Bronchoscopy helps to detect the source of bleeding. For these purposes, rigid or flexible bronchoscopes are used. With the help of a hard one, you can help with bleeding, since this device is able to suck out the blood entering the bronchi. A flexible bronchoscope has the advantage of being able to show a more detailed picture of the state of the respiratory organs.

If pulmonary hemorrhage is repeated, contrast X-ray diagnostics are performed. Thus, arteriorrhaphy is based on contrast x-rays of the blood arteries in the bronchi.

When and which doctor should I contact?

You should consult a doctor as soon as the first symptoms appear.

1. If sputum with blood with or without coughing lasts more than three days;
2. When this is accompanied by weakness, weight loss or lack of appetite;
3. With severe chest pain and shortness of breath that does not stop even in a calm state.

You should contact your local physician, who will make a preliminary diagnosis and, if necessary, refer you to a specialized specialist - a phthisiatrician, oncologist or pulmonologist, for a detailed diagnosis.

What drugs are used in the hospital?

The use of any drugs is prescribed after hardware studies are carried out, in order to accurately understand what course of therapy is necessary. You need to know that some drugs act in a way that temporarily stops bleeding. But the most effective treatment method is surgery.

The doctor prescribes the treatment method for the pathology depending on the cause of its occurrence.

Medicines are prescribed only by a doctor after examination. Hemoptysis itself is only a symptom of the disease, and treatment will depend on this disease. If you have hemoptysis, you should contact a therapist, phthisiatrician or oncologist. Most often, the patient turns to a therapist, and after the initial examination, he refers to a more specialized specialist.

The drugs should not be taken without a doctor’s recommendation and examination, since it is impossible to diagnose yourself. Incorrect treatment can not only not help, but also harm.

As a rule, treatment is aimed at eliminating the causes of hemoptysis, as well as restoring the normal functioning of the lungs, bronchi, blood vessels, and preventing asphyxia:

• Antitussive drugs. Codeine-based medications are often prescribed to suppress the cough reflex. Despite the discharge of sputum, coughing fits cannot be useful in case of bleeding. They further damage and irritate the bronchi and can increase hemoptysis.
• Plasma replacement. If blood loss is significant, the doctor will prescribe a plasma transfusion to support the body's functioning.
• Hemostatics. For hemoptysis, hemostatic drugs such as Dicynon and Etamzilate are prescribed. They help stop bleeding, improve blood flow and vascular permeability. For pulmonary hemorrhage, they are often administered intravenously or intramuscularly.
• Painkillers. Hemoptysis often causes pain, so the patient is prescribed painkillers such as Analgin. For severe pain, narcotic drugs are prescribed.
• Antibiotics. Antibacterial drugs are often prescribed for tuberculosis and other diseases caused by bacteria. Treatment of tuberculosis is long and difficult, so strong antibiotics are often prescribed: Streptomycin, Rifabutin, Isoniazid (an anti-tuberculosis drug).
• Chemotherapy. Antitumor drugs are prescribed for lung cancer and other serious diseases in which the risk of tumors is very high. Chemotherapy is carried out in courses and is often difficult to tolerate by patients due to side effects, but for cancer it is the only effective treatment.

Diagnostics - looking for the cause of blood in sputum

An important diagnostic criterion in determining the source of hemorrhages (bleeding) is the type of blood and its color.

For example, coughing up sputum with blood of a foamy consistency and scarlet color indicates hemorrhage in parts of the respiratory system, and its dark red or coffee color indicates bleeding in the gastrointestinal tract.

Sometimes blood enters the sputum from the paranasal sinuses or from the chaons connecting the pharynx to the nasal cavity. Hemorrhages can be triggered by an infectious process or cancer pathology.

To clarify the diagnosis, the following may be prescribed:

• X-ray examination - identification of pulmonary pathologies.
• CT examination to identify the localization of pathology and the nature of possible changes in lung tissue.
• Bronchoscopic examination - identification of visible pathologies in the bronchial lumens.
• Examination of sputum and blood to detect tuberculosis infection and inflammatory processes in the bronchopulmonary system.
• Analysis of the composition of sweat to exclude respiratory cystic fibrosis.
• Study of cardiac activity using cardiography.

Hemoptysis

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Treatment protocol - sputum with blood

If the process of hemoptysis is prolonged, the patient is hospitalized in the department of general or thoracic surgery. As emergency measures, depending on the patient’s condition, until the exact causes are clarified, the following may be prescribed:

1. Various oxygen therapy techniques;
2. Maintenance of lung ventilation;
3. Tracheal intubation using the Bonika method (under anesthesia);
4. Vein catheterization;
5. Administration of hemostatic drugs.

If the pathology that causes hemoptysis is identified, therapeutic therapy is prescribed, according to the treatment protocol, or surgical intervention that eliminates the cause.

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Who is at risk

Most often at risk associated with serious illnesses and bleeding from the respiratory tract:

• elderly and senile people;
• HIV-infected persons;
• heavy smokers and substance abusers;
• patients taking immunosuppressants;
• persons with a history of thrombosis.

Thromboembolism of the pulmonary arteries in some people may occur suddenly after a long trip (due to prolonged sitting in transport).
The causes of this condition can be very diverse, so only an experienced specialist can prescribe adequate and timely treatment after examining the patient and carrying out a number of diagnostic measures.

Depending on the type of disease, its stage and the depth of damage to the respiratory system, the doctor will select an individual treatment regimen and medications.

If we are talking about tuberculosis, then treatment is carried out with the help of anti-tuberculosis and immunomodulatory drugs. In other cases, antiviral or antibacterial medications may be needed. Some diseases can only be cured through surgery.

It is important to remember that if hemoptysis appears and systematically repeats, this is an alarming symptom. Only a qualified doctor can answer how to treat a patient, and self-medication is unacceptable and extremely life-threatening.

Necessary emergency measures

If you find a person with signs of pulmonary hemorrhage, you must immediately dial 103 and inform the ambulance dispatcher the passport details of the victim, the address where he is located, and the main complaints:

• appearance of blood from the mouth,
• chest pain
• accompanying cough.

What to do if there is no doctor nearby

The first step is to determine whether the victim is conscious or not.

The person is conscious

Before the team of specialists arrives, the victim is provided with emergency care for pulmonary hemorrhage. Emergency measures should be aimed at reducing the volume of blood loss and maintaining patency of the airways throughout their entire length.

Unconscious man.

If the victim is unconscious, it is necessary to ensure airway patency. First, you need to turn the patient on his healthy side and tilt his head back so that he can breathe. This position will allow the liquid that has collected in the mouth or throat: blood, secretions, vomit - to flow out, and it will not enter the victim’s respiratory tract.

Actions of the medical team

The emergency physician will be able to assess the patient's condition and determine the possible cause of the bleeding. At the prehospital stage, medications are administered that help stop bleeding (Dicinone, Etamzilat, Vikasol, calcium gluconate).

At the same time, oxygen supply is ensured using a breathing mask or the necessary equipment, after which the patient is taken to the hospital in a semi-sitting position.

The video in this article tells more about medical care for pulmonary hemorrhage.

Hemorrhage into the lungs: treatment

The following drugs and methods are used to treat hemorrhage in the lungs:

• medications whose action is aimed at stopping bleeding;
• antibiotics, the action of which ensures an adequate level of prevention of infectious manifestations;
• means to enhance expectoration, the action of which is aimed at accelerating the release of sputum when it is difficult;
• oxygen therapy, which involves its delivery with special masks and devices;
• localization and subsequent complete elimination of the underlying painful condition that caused the pulmonary hemorrhage;
• a surgical operation that involves removing some part of the lung.

Forecast

Even a one-time and spontaneously stopped pulmonary hemorrhage is always potentially dangerous in terms of recurrence. Excessive pulmonary hemorrhage threatens the patient's life. In severe cases, death occurs as a result of asphyxia caused by blockage of the airways with blood clots and simultaneous spastic contraction of the bronchi. The percentage of postoperative complications and mortality during operations performed at the height of pulmonary hemorrhage is more than 10 times higher than similar indicators during planned operations.

Pulmonary hemorrhage in children

Symptoms of pulmonary hemorrhage can appear in newborns - usually even before the baby is born, doctors may suspect the possibility of such a complication. Immediately after birth, such children are placed in the intensive care wards of the children's department, where they are closely monitored and treatment is started when the first signs of pathology appear.

The causes of this condition can be both complications that arose during childbirth and problems associated with the course of pregnancy. This condition can be provoked by congenital heart defects, as well as disorders in the blood coagulation system with a tendency to hypocoagulation.