Hemoptysis causes, symptoms and treatment. Causes of pulmonary hemorrhage and hemoptysis

Hemoptysis - coughing up blood - can manifest itself as separate streaks of blood in the sputum, or spit can consist of only blood. Coughing up a large amount of blood (more than 100 ml per day) is called pulmonary hemorrhage.

If 600-800 ml of blood is lost within 24 hours, there is a threat to life due to aspiration of blood and asphyxia. However, the division into hemoptysis and pulmonary hemorrhage is relative. Any hemoptysis is a sign of an emergency, since it is never possible to say with certainty that minor hemoptysis will not be followed by heavy pulmonary hemorrhage. The source of bleeding may be the vessels of the system pulmonary artery or bronchial vessels. Provoking factors can be exercise stress, decreased atmospheric pressure, infection, insolation.

Hemoptysis can occur with a number of lung diseases, including inflammatory (bronchitis, bronchiectasis, pneumonia, lung abscess, tuberculosis), neoplasms ( lung cancer, bronchial adenoma), heart and vascular diseases (mitral stenosis, pulmonary embolism, aortic aneurysm), trauma chest, autoimmune diseases(Goodpasture's syndrome, Wegener's granulomatosis).

Hemoptysis is observed in lung diseases accompanied by decay lung tissue, with involvement of pulmonary vessels in the zone of decay, disruption of integrity vascular wall. In this case, the amount of bleeding largely depends on the caliber of the damaged vessel.

Among lung diseases, tuberculosis remains one of the common causes of hemoptysis. Hemoptysis can complicate any form of pulmonary tuberculosis: infiltrative outbreak, hematogenous dissemination, fibrocavernous process. It should be borne in mind that sometimes hemoptysis is the first symptom of tuberculosis noticeable to the patient. Usually it is not profuse and life-threatening, but one must always remember the possibility of fatal bleeding.

Anamnestic data help in diagnosing tuberculosis: the presence of pulmonary tuberculosis in the past, symptoms of exacerbation of the process and tuberculosis intoxication - fever, night sweats, weight loss, increased fatigue, debilitating cough.

Most common cause hemoptysis are non-tuberculous suppurative diseases of the lungs, and among them primarily bronchiectasis and lung abscess. A change in the structure of pulmonary diseases and a decrease in the proportion of tuberculosis have led to the fact that in recent decades, bronchitis and bronchiectasis as the cause of hemoptysis have been in first place, causing almost half of all cases of hemoptysis. Hemoptysis with bronchiectasis and abscesses is usually not profuse, but tends to recur frequently, especially during periods of exacerbation of the chronic suppurative process. Perennial cough a large number of sputum, especially in the morning ( mouth full), changes nail phalanges fingers in the form of “drum sticks” or nails in the form of “watch glasses”, percussion and auscultation signs of emphysema and pneumosclerosis reliably help in diagnosing bronchiectasis as the cause of hemoptysis.

The admixture of blood to mucous sputum or the coughing up of pure blood is often observed in acute period pneumonia (especially viral influenza). In these cases, hemoptysis is combined with chills, high temperature, often shortness of breath, chest pain when breathing. Objective examination reveals shortening percussion sound and moist rales in the area of ​​inflammation.

Hemoptysis - common symptom lung neoplasms. About a quarter of all cases of hemoptysis are caused by benign and malignant lung tumors. The admixture of blood to sputum gives last view raspberry jelly. It should be emphasized that hemoptysis and a persistent debilitating cough may be the early and for some time the only complaints of a patient with lung cancer. In these cases, the success of subsequent surgical treatment often depends on how soon after the onset of cough and hemoptysis the patient was referred to X-ray examination and was diagnosed with lung cancer.

In addition to lung diseases, hemoptysis can occur with heart diseases, accompanied by stagnation of blood in the pulmonary circulation, especially with narrowing of the left venous opening - mitral stenosis. Hemoptysis in this case occurs as scarlet blood, in the form of streaks, usually not very profuse, after which shortness of breath sometimes decreases and the well-being of patients improves. Anamnestic information about rheumatism and heart disease, characteristic appearance sick mitral disease(acrocyanosis, “mitral blush”), data from an objective examination of the heart (expansion of the borders of the heart upward and to the right, flapping 1st sound and diastolic murmur at the apex, click of the mitral valve opening, accent and bifurcation of the 2nd sound on the pulmonary artery, as a rule, atrial fibrillation). Prescribing appropriate cardiac and diuretic drugs to patients with hemoptysis with mitral stenosis usually significantly improves the condition and leads to a significant reduction or cessation of hemoptysis.

Hemoptysis can be caused by stagnation in the vessels of the pulmonary circulation due to acute and subacute failure of the left ventricle of the heart in patients with hypertension, atherosclerotic cardiosclerosis, and myocardial infarction. Typically, hemoptysis in these patients is preceded by an attack of cardiac asthma, or shortness of breath increases so sharply that patients cannot lie down and are forced to sit for days with their legs down. Hemoptysis is not profuse. First, patients cough up spitting scarlet blood, which gradually darkens as the hemoptysis decreases. A repeated attack of suffocation can lead to relapse of hemoptysis, i.e. hemoptysis appears with increasing failure of the left ventricle of the heart and increased congestion in the lungs. Effective cardiotonic and diuretic therapy in these patients usually leads to cessation of hemoptysis along with improvement in condition, reduction of shortness of breath and pulmonary congestion.

Relatively rare cause pulmonary hemorrhage There is a breakthrough of an aortic aneurysm into the bronchus. Bleeding usually leads to instant death. However, sudden bleeding is sometimes preceded several days or weeks by the so-called premonitory hemoptysis, caused by both compression of the bronchial mucosa and the leakage of small amounts of blood through the thinned wall of the aneurysm into the bronchus.

One of the causes of hemoptysis is pulmonary infarction. In this case, hemoptysis is combined with sudden shortness of breath, chest pain, and fever. Anamnestic information and examination data can detect pathology of the heart and blood vessels (heart disease or cardiosclerosis with atrial fibrillation, venous thrombosis lower limbs), the ECG reveals signs of overload of the right heart.

Hemoptysis can be observed with chest injuries accompanied by hemorrhage into the lung tissue, sometimes even in the absence of visible damage skin and damage to the integrity of the ribs. The cause of hemoptysis may be foreign bodies that enter the lungs during old wounds or are aspirated into the bronchi. In these cases, hemoptysis is caused by the breakdown of lung tissue as a result of the formation of bedsores from foreign body, reactive inflammation and atelectasis.

Diagnosis of hemoptysis is usually not difficult. It never occurs in a dream, since coughing wakes the patient. During pulmonary hemorrhage, blood is always coughed up and is usually scarlet in color and foamy. In rare cases, difficulties arise in differential diagnosis between pulmonary and gastric bleeding, especially if the patient swallowed part of the blood during pulmonary bleeding and subsequently experienced hematemesis. Below is Comparative characteristics gastric and pulmonary bleeding (Table 3).

Differential diagnosis of pulmonary and stomach bleeding

Basic principles therapeutic tactics for pulmonary hemorrhage:

1. 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 hemoptysis. Hemoptysis, especially when occurring for the first time, usually frightens the patient and others, so you need to reassure the patient if possible. However sedatives used with great caution, as they can reduce protective reflexes and mask increasing respiratory failure; Tranquilizers that have a muscle relaxant effect (including on the diaphragm) are especially dangerous.

2. After providing emergency care, a patient with hemoptysis should be 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 complex therapeutic measures, aimed at stopping pulmonary hemorrhage, and a more detailed examination to determine its cause. In particular, patients with hemoptysis require 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, if hemoptysis occurs, he should not be referred to general hospitals, and to specialized anti-tuberculosis institutions.

Hemoptysis is the production of sputum when coughing, which contains blood or a significant admixture of blood. Depending on the pathology that provoked this condition, the sputum may be uniformly colored brown, pink or scarlet. In some cases, only streaks of blood are visible in the discharged sputum. The discharged mucus may be jelly-like or foamy; the disease can also be differentiated by this feature. The causes of hemoptysis are different and there are many of them. This condition is mainly caused by serious illnesses lower respiratory organs.

Causes

Hemoptysis is the inclusion of blood in the sputum expelled by coughing. The amount of blood may vary, depending on the pathology that provoked this phenomenon. Most often, this pathological condition is caused by pulmonary tuberculosis, advanced bronchitis and pneumonia. But there are many other diseases that provoke such pathology.

The main causes of hemoptysis include the following diseases and conditions:

• Pathologies of the lower respiratory tract– pneumonia, bronchitis, tuberculosis and abscesses of lung tissue.
• Pathological neoplasms – adenomas and tumors of various types.
• Diseases of the heart and blood vessels. Aortic aneurysm, stenosis and pulmonary embolism can provoke the appearance of blood in sputum.
• Injuries to the sternum, especially with rib fractures.
• Autoimmune diseases - Wegener's granulomatosis and some other pathologies.

Hemoptysis often occurs with lung diseases that occur with rapid decomposition of lung tissue. IN such a case are destroyed blood vessels, and blood enters the tissues.

This phenomenon is often observed during suppurative processes in the lungs. In almost half of the cases, such people are diagnosed with bronchitis or bronchiectasis. In such a case, the discharge of blood is insignificant, but this condition continues for quite a long time and is especially pronounced with the relapse of many diseases.

Hemoptysis with bronchitis is mild. In this case, streaks of blood are observed in the discharged sputum, which indicate damage to the bronchial tissue. If such a phenomenon occurs during bronchitis. You need to notify your doctor. In certain cases, treatment is revised and drugs are added to strengthen blood vessels.

A small admixture of blood or the discharge of pure blood is often observed in the most acute period of pneumonia. Hemoptysis with pneumonia always occurs with high body temperature, shortness of breath, deterioration in general health and severe pain in the sternum.

The causes of hemoptysis include various tumors lower respiratory organs. In every 4th case, benign as well as malignant lung tumors are diagnosed. In oncological pathologies, the discharged sputum has the appearance of raspberry jelly. One of the most striking symptoms of lung cancer is hemoptysis and severe cough.

If the cough does not go away for a long time and there is blood in the sputum, you should see a doctor. It must be remembered that most of diseases are better treated at an early stage.

In addition to diseases of the respiratory organs, some pathologies can also lead to hemoptysis of cardio-vascular system. This is often observed in diseases that occur with stagnation of blood in a small area of ​​the circulation. The most common cause of blood in the sputum is mitral stenosis. With this disease, only bloody streaks are observed in the sputum. After the sputum and blood are discharged, it becomes easier for the patient to breathe and his health improves significantly.

Blood in the sputum also occurs when there is significant stagnation of blood, which is caused by acute or subacute failure of the left ventricle of the heart. This phenomenon is observed in cardiosclerosis, hypertension and myocardial infarction. In most cases, the appearance of blood in the sputum is preceded by a severe attack of cardiac asthma. With all these pathologies, the patient first simply spits scarlet blood, and then it becomes darker. With each new attack of severe suffocation, hemoptysis resumes.

In very rare cases, hemoptysis begins due to a rupture of an aortic aneurysm into the bronchial cavity. In such a case, pulmonary hemorrhage develops very quickly, which leads to the death of a person in a matter of minutes. However, you need to understand that hemoptysis, which precedes a breakthrough of the aorta, occurs a week before the pathology. This occurs due to compression of the bronchial mucosa and blood entering the bronchi through the aneurysm.

With a pulmonary infarction, profuse hemoptysis is also observed. This condition is accompanied severe pain in the sternum, shortness of breath and significantly elevated temperature.

Profuse hemoptysis is observed with sternum injuries. Especially dangerous condition considered a rib fracture.

A similar phenomenon often occurs when a foreign body accidentally enters the lower respiratory organs. This occurs due to the decomposition of lung tissue, which occurs when severe inflammation.

Blood in the sputum can also be caused by bedsores, which often occur in bedridden patients. To prevent this phenomenon, it is necessary to use special anti-decubitus mattresses and often turn the patient over.

In some cases, people mistake blood in saliva for hemoptysis. But this phenomenon occurs due to bleeding gums or injury to the oral mucosa.

Diagnostics

To find out the causes of hemoptysis, the doctor collects anamnesis, examines the patient and, if necessary, refers for examination. The doctor should visually assess the nature of the expectorated sputum. In most cases, it is already possible to put preliminary diagnosis. The nature of the outgoing blood will help differentiate pulmonary bleeding from gastric bleeding or from ordinary bleeding gums.

When making a diagnosis, the patient’s lungs must be listened to. If local wheezing is heard, the doctor may suspect lung carcinoma. Wet wheezing most often indicates pneumonia or bronchitis.

To clarify the diagnosis, the patient must be sent for a chest x-ray. From the resulting image, you can determine the nature of the damage to the bronchi and lungs, as well as assess the severity of the patient’s condition.

In certain cases, bronchoscopy and CT of the chest organs are prescribed to make a diagnosis.

Treatment

The tactics of treatment used directly depend on the reasons that provoked hemoptysis. Only a qualified doctor can determine the root cause of this phenomenon. Before the specialist arrives, the patient must be given first aid to minimize the risk of developing serious complications. Delivery algorithm emergency assistance

• such:
• The patient is placed in a semi-sitting position and conversations with him are limited.
• You can slightly reduce bleeding if you give the patient small pieces of ice to suck. If hemoptysis occurs for the first time. It can be very frightening for the patient. First priority

in this case, reassure the patient.

While one person provides first aid to the patient, the second must call a doctor. Over the phone, you need to tell what exactly is bothering the patient; in some cases, they send out a resuscitation team. Hemoptysis is most often treated in a hospital setting. Depending on the patient’s condition, he may be placed in the pulmonology department or department intensive care . Doctors carry out a set of measures to identify the cause pathological phenomenon

and stopping pulmonary hemorrhage.

Symptomatic treatment is carried out, which is aimed at reducing coughing attacks, during which the patient’s condition worsens. To do this, the patient is given antitussive drugs, for example, Codeine. If the patient’s condition is serious and worsens every minute, Promedol is prescribed, which is administered intramuscularly or intravenously.

If the bleeding is severe, a blood transfusion may be prescribed. Sometimes an infusion of colloidal or saline solutions is indicated to normalize the volume of circulating blood. If there is a danger of suffocation, tracheal intubation is performed and a catheter is inserted into the damaged bronchus. The most life-threatening condition is when a patient loses up to 800 grams of blood per day. In this case, they often resort to surgical treatment pathological condition.

Surgery is most often used for cavernous tuberculosis, lung cancer and abscesses. A patient with hemoptysis should be constantly monitored by health workers, as the condition can worsen very sharply. The main care for the patient is to follow bed rest , regular measurement blood pressure

You need to understand that hemoptysis can be a symptom of very serious pathologies, some of which quickly lead to the death of the patient. If even a little blood appears in the discharged sputum, you need to inform your doctor about this, who will identify the cause and select necessary treatment. Self-medication is not worth it, in most cases it has no effect and only wastes precious time.

Hemoptysis is the process of coughing up blood. In this case, blood may be present in the secretions of the respiratory tract in the form of separate veins, or the entire contents of the spit may consist only of blood. Any hemoptysis is a sign emergency, since a mild cough with blood may be followed by heavy pulmonary hemorrhage.

Diagnosis of diseases that cause the manifestation of this symptom is based on radiography, computed tomography, and bronchoscopy.

Treatment of hemoptysis depends on the causes that cause it.

Causes of hemoptysis

The manifestation of hemoptysis syndrome can result from:

• Pulmonary diseases (pneumonia, bronchitis, tuberculosis, bronchiectasis, lung abscess);
• Neoplasms of the respiratory tract (bronchial adenoma, lung cancer);
• Cardiovascular diseases (aortic aneurysm, pulmonary embolism, mitral stenosis);
• Chest injuries;
• Autoimmune diseases (Wegener's granulomatosis, Goodpasture's syndrome).

Pulmonary hemoptysis occurs with lung diseases that are accompanied by the breakdown of lung tissue. In this case, the pulmonary vessels are involved in the decay zone, and their walls are destroyed.

The most common cause of hemoptysis among pulmonary diseases is tuberculosis. In some cases, hemoptysis syndrome is the first noticeable sign of this disease.

Besides, pulmonary hemoptysis may occur with non-tuberculous suppurative lung diseases. Almost half of all cases of this symptom are explained by the presence of bronchitis and bronchiectasis. Hemoptysis in these diseases is usually not profuse, but is repeated quite often, especially with exacerbation of chronic suppuration.

An admixture of blood in the sputum or the release of pure blood along with a cough quite often occurs in the acute period of pneumonia. In this case, hemoptysis syndrome is accompanied by fever, chills, shortness of breath, and chest pain during breathing.

Hemoptysis is also a common symptom lung tumors. About 25% of all cases of pulmonary hemoptysis are associated with benign and malignant neoplasms in the lungs. IN in this case the admixture of blood gives the sputum the appearance of raspberry jelly. A hacking cough and hemoptysis are the early and only complaints of initial stages lung cancer

In addition to pulmonary diseases, hemoptysis can be caused by heart diseases, which are accompanied by stagnation of blood in the vessels of the pulmonary circulation with mitral stenosis. In this case, the blood released when coughing looks like scarlet streaks in the sputum, hemoptysis is not very profuse and leads to a decrease in shortness of breath and an improvement in the patient’s well-being.

Hemoptysis can be caused by blood stagnation in acute and subacute left ventricular failure in patients with atherosclerotic cardiosclerosis, hypertension, and myocardial infarction. As a rule, the appearance of hemoptysis in such patients is preceded by an attack of cardiac asthma. With these diseases, the spittle of scarlet blood is first coughed up, which then darkens. A new attack of suffocation leads to recurrence of hemoptysis.

A fairly rare cause of hemoptysis is the rupture of an aortic aneurysm into the bronchi. The subsequent pulmonary hemorrhage leads to the instant death of the patient. But hemoptysis, which heralds the development of bleeding, can begin several days or weeks before. It is caused by compression of the bronchial mucosa and blood leaking into the bronchus through the wall of the aneurysm.

With a pulmonary infarction, hemoptysis syndrome also occurs, which is combined with sudden chest pain, shortness of breath, and fever.

Hemoptysis also occurs with chest injuries, which are accompanied by hemorrhage into the lung tissue.

Spitting blood can also occur when foreign bodies enter the lungs. Hemoptysis in these cases occurs as a result of the breakdown of lung tissue during reactive inflammation, the formation of a bedsore from a foreign body, or atelectasis.

Diagnosis of hemoptysis

When identifying the causes that led to hemoptysis, it is important to collect a similar history, correctly interpret the patient’s complaints, evaluate the nature of coughed up sputum in order to differentiate pulmonary hemoptysis from bleeding of the gastrointestinal tract.

In order to diagnose the causes of the described syndrome, a physical examination is performed. The presence of local crackles will indicate possible lung carcinoma; moist rales in the area of ​​inflammation and shortening of the percussion sound indicate pneumonia.

The initial examination includes a chest x-ray.

Also, to clarify the diagnosis, it may be prescribed CT scan and tracheobronchoscopy.

Treatment of hemoptysis

Determining the treatment strategy for hemoptysis depends on what causes it.

But before establishing the conditioning this syndrome factors, if necessary, the patient should be given first aid for hemoptysis. To do this, you need to try to reduce conversations with the patient and give him a semi-sitting position or lay him on his side to prevent blood from entering the healthy lung. To reduce the process of bleeding, you can give the patient a piece of ice. Hemoptysis that occurs for the first time frightens the patient, so he needs to be reassured.

After providing first aid for hemoptysis, the patient must be hospitalized for a set of measures to stop pulmonary hemorrhage and a thorough examination.

Purpose symptomatic treatment hemoptysis is suppression of cough, which can worsen the condition. For this, codeine is used (orally); as an emergency aid for hemoptysis, painful cough and severe pulmonary bleeding, promedol is administered subcutaneously or intravenously.

At life-threatening In cases of severe pulmonary hemorrhage, hemostatic therapy is used. If signs of hypovolemia appear, colloidal or saline solutions to replenish the volume of circulating blood.

If there is a danger of asphyxia, then tracheal intubation is performed by inserting a catheter with an inflatable balloon into the affected bronchus.

The main threat to life is massive hemoptysis with a loss of 600-800 ml of blood per day. In this case, a decision must be made on surgical or conservative management. Surgical intervention more often used in patients with anaerobic lung abscess, cavernous tuberculosis, and lung cancer.

Thus, hemoptysis may be a sign of many serious illnesses. Therefore, when it appears, you should immediately contact medical care to prevent death.

A cough that produces bloody sputum should always alert a person and force him to immediately consult a doctor. The fact is that hemoptysis (hemoptysis) is almost always a sign of a serious illness, and some diseases with the release of blood from the lungs and respiratory tract require emergency hospitalization and surgical treatment person.

Features of the disease

Almost nothing happens without a cough infection ENT organs, and this function is normal for human body- helps the respiratory tract get rid of viruses, bacteria and mucus accumulation. But sometimes a person may notice not ordinary sputum, but its coughing up with blood, when the mucus becomes pink tint or contains obvious pathological inclusions. Bloody sputum is more common in older people. No matter how small the amount of blood in the sputum, no matter what time this phenomenon occurs - in the morning, during the day, whether the bleeding is accompanied by a cough or not - you should urgently visit a specialist.

Hemoptysis (hepotysis) is a symptom of coughing and secretion of mucus (sputum) mixed with blood from the bronchi, lungs or larynx. It is easy to understand that normally there should be no streaks of blood in the sputum, as well as in “standard” inflammatory diseases of the respiratory tract over time. moderate severity. Many of the conditions that arise, accompanied by hemoptysis, potentially threaten serious problems and even death, so you cannot hesitate in such a situation.

Sometimes in older people, or with severe inflammation and tissue irritation respiratory system the mucous membrane is so irritated and swollen that it is easily injured and can release droplets of blood. But prolonged hemoptysis or excessive pulmonary bleeding are serious types of pathology, the causes of which require careful analysis, because they can lie in oncological problems, tuberculosis and a host of other diseases.

Why does hemoptysis occur?

Occasionally, it still happens that the cause of hemoptysis cannot be found, or it does not have a serious underlying cause, and the disorder goes away on its own over time. In most cases, hemoptysis is a symptom of unpleasant and dangerous diseases. In people under 40 years of age, tuberculosis should initially be suspected; in older people, especially smokers, lung cancer. Many doctors even note the particular importance of reliably excluding these diagnoses, since they account for more than half of all cases of hemoptysis. If the diagnoses are not confirmed, the cause of hemoptisis is most often bronchiectasis: this symptom, if it recurs regularly, is highly likely in the presence of bronchiectasis.

Other diseases that can provoke the release of blood from the respiratory tract may include:

• acute bronchitis;
• Chronical bronchitis;
• pneumonia;
• aspergilloma;
• Wegener's granulomatosis;
• TELA;
• stenosis mitral valve;
• laryngeal cancer;
• pulmonary edema;
• fungal infection of the lungs;
• silicosis;
• lung abscess.

IN childhood Hemoptysis with cough can be triggered by the entry of a foreign body into the bronchi. Also, long-term and poorly controlled use of heparin anticoagulants, which thin the blood and promote bleeding, can also play an important role in the pathogenesis of hemoptysis. various localizations. Lung trauma can also cause hemoptysis, as can a long history of smoking with the development chronic diseases lower respiratory tract.

Symptoms of manifestation

Sometimes blood in the mouth appears for a completely different reason than its release from the respiratory tract. Thus, blood is sometimes noted during vomiting, or its streaks are observed in the mucus secreted from the nose, which is easy for an ignorant person to confuse. There are signs that distinguish hemoptysis from other types of bleeding:

• when the blood flows from digestive tract, it takes on a dark brown color, reminiscent of coffee grounds, because it is partially digested;
• if the bleeding comes from the nose or paranasal sinuses, it represents streaks or blood clots present in the yellow or greenish mucus, and the disease is usually accompanied by the main symptoms of inflammation of the ENT organs;
• with hemoptysis, after mixing with air, the blood takes the form of homogeneous bright red or pink sputum, or large, bright inclusions in the sputum, while massive bleeding is accompanied by the appearance of scarlet, foamy blood even without a strong cough.

The pathology clinic will also largely depend on the cause of hemoptisis. For example, when fluid accumulates in the lungs against the background of their edema, there may be bad taste blood in the mouth. At severe injury a sudden cough appears in the chest, during which scarlet blood is released without sputum. Tuberculosis leads to the production of sputum containing blood and pus, which smells unpleasant. Lobar pneumonia may produce “rusty” homogeneous sputum from the lungs. Lung and bronchial cancer produces moderate bleeding, more often in the morning, but this symptom recurs regularly.

U smoking people There is a high risk of lung cancer when small amounts of fresh blood appear over a period of several days. Other symptoms of hemoptysis may include low-grade fever or fever, including prolonged fever, chest pain, shortness of breath, and poor general health of the person.

Massive bleeding (more than 200 ml of blood per day) is not included in the concept of “hemoptysis” and is recognized as a separate syndrome that corresponds to many acute diseases and injuries.

Diagnosis of diseases

With hemoptysis, a detailed collection of anamnesis of the disease, assessment and analysis of the complaints presented by the patient often come to the fore, because there are a lot of diseases that have such a symptom. The doctor should be especially interested in such facts as past hemoptysis and its cause, smoking and others. bad habits, presence of chest injuries, previous acute respiratory viral infections, bronchitis, pneumonia, recently performed dental procedures and invasive examinations, other existing symptoms (fever, pain, diarrhea, nausea, etc.).

If at serious bleeding a person needs urgent Care, then with regular hemoptysis, as a rule, a detailed, step-by-step examination is carried out. To differentiate the release of blood from the lower respiratory tract and from the larynx, nose, sinuses and gastrointestinal tract, as well as to search for the cause, the following diagnostic methods are used (according to indications):

1. chest x-ray;
2. CT or MRI;
3. bronchoscopy;
4. bronchography;
5. selective angiography of pulmonary vessels;
6. tuberculin tests;
7. general analysis blood;
8. coaulogram;
9. general urine analysis;
10. blood biochemistry;
11. laboratory examination of sputum.

As a rule, with hemoptysis, the patient does not develop anemia, unlike massive pulmonary hemorrhage. Only a very long existence of the pathology can cause a lack of hemoglobin, which, unfortunately, almost always indicates the presence malignant tumors or severe autoimmune diseases.

Conservative treatment

Blood from the lungs can be released in different quantities, which will determine the tactics of providing care to the patient. Minor bleeding - up to 100 ml of blood per day, medium - 100-500 ml, profuse - over 500 ml. If there is a significant volume of bleeding, you should urgently call an ambulance, because this may become a sign of chest injury or other cause of severe bleeding . Before the car arrives, the patient should be given first aid. first aid : make him sit half-sitting, provide physical rest, access fresh air

1. , try not to worry. Other actions at home:
2. At Explain to the person that there is no need to suppress the cough; on the contrary, it is better to cough up all the blood from the lungs. This is necessary to prevent aspiration pneumonia. you need to apply tourniquets to the limbs to deposit blood in the arms and legs. Hips and shoulders should be tightened with tonometer cuffs and a rubber bandage.

Patients with hemoptysis with severe course diseases should be sent to a hospital under the supervision of a thoracic surgeon, or to the department general surgery. The person is given emergency diagnostic measures, oxygen therapy is prescribed. Sometimes anesthesia, mechanical ventilation, tracheal intubation, catheterization may be required central vein. Pulse and diuresis should be monitored and, if necessary, administered colloidal solutions. The administration of Epinephrine through the endobroncheal route, as well as the administration of platelet concentrate, hemostatic agents, and aminocaproic acid, will help stop bleeding.

After identifying the cause of the disease, special therapy is carried out aimed at eliminating it. Treatment may include the following methods and drugs:

• antibiotics;
• glucocorticosteroids;
• mucolytics;
• high blood pressure medications;
• chemotherapy, radiation;
• drugs against bronchospasm;
• medicines against tuberculosis, etc.

Some patients may be indicated for surgical treatment - for lung cancer, abscess, trauma, tuberculous cavernoma and other severe pathologies. Stopping bleeding is also practiced. surgically by introducing pieces of Teflon, silicone and other artificial emboli into the pulmonary vessels, which will clog the source of blood secretion.

Therapy with folk remedies

Treatment in unconventional ways can only be carried out after a thorough diagnosis and reliable investigation of the cause. When hemoptysis occurs, treatment should not be delayed, so relying on folk remedies is strictly prohibited!

1. If your doctor approves, you can use the following recipes for hemoptysis:
2. Prepare a collection of chicory leaves, nettles, knotweed, and agrimony, taking the raw materials in equal quantities. Brew 2 tablespoons of the mixture with 350 ml of boiling water, leave for an hour. Drink 100 ml three times a day. Course - 7-14 days. Extract the juice from the sorrel and hare cabbage
3. , take a spoonful of juices twice a day.
4. Mix equal parts prunes and raisins, cook compote, adding a glass of fruit per liter of water, season with sugar. Drink 2 glasses of compote per day. Grind fresh milk thistle seeds, combine 1:1 with hot water

The nutrition program must correspond to the underlying disease. Most often, a person is recommended to have a gentle diet with no spicy, irritating, fatty foods, and an abundance of vitamins and minerals. All dishes should be small in volume, but nutritious enough. It is better to cook food boiled or steamed. Only with tuberculosis will a person need food with increased calorie content, which will help him recover more quickly from a serious illness.

• avoid stress, nervous overload, overwork;
• Avoid heavy lifting and intense physical training;
• ventilate the room more often;
• take regular walks outdoors;
• often stay in a cool room;
• drink cold water in small sips;
• pour cool water over your head and neck.

Features of pathology in pregnant women

The appearance of such symptoms in a pregnant woman should prompt her to immediately visit a doctor. The causes of hemoptisis in women during gestation can be all of the above diseases, as well as progressive gestosis and its formidable complications- preeclampsia, eclampsia. All these conditions can lead to the death of mother and child, so most often pregnant women with hemoptysis are hospitalized until the causes of the pathology are clarified.

Treatment depends entirely on the prerequisites for the onset of hemoptysis. In addition to the necessary and permitted medications during pregnancy, it is recommended balanced diet With high content fiber, daily walks in the air for 2 hours or more. According to indications for some diseases, termination of pregnancy is recommended if the risk of carrying a fetus without treatment is too high for the life of the mother.

What not to do

The following actions are prohibited during treatment for hemoptysis:

• taking hot drinks;
• alcohol consumption, smoking;
• consumption of fatty foods;
• exercise, if the doctor notes the need complete failure from physical education;
• making sudden, fast movements;
• shouting, raising voice;
• constipation (you should give enemas or take special drugs from constipation);
• being in a stuffy room.

Preventive measures

To avoid having to search for the cause of the disease, the following preventative measures should be taken:

• prevent irritation of the respiratory tract from industrial and household products; allergens, air pollutants;
• use masks and other protective equipment if necessary;
• no smoking;
• do fluorography regularly, especially after 45 years;
• do not live in places with poor ecology;
• Healthy food;
• don't give infectious diseases become chronic;
• do sports, do not allow