Hemoptysis Bloody cough

Hemoptysis and hemoptysis

Hemoptysis is generally a very serious symptom associated with various serious respiratory diseases. A medical examination of the complaints is therefore urgently required - in case of doubt, an emergency doctor should be alerted.

contents

definition
symptoms
causes
Respiratory infections
Cancer and hemoptysis
Other causes of hemoptysis
Diagnosis and treatment of hemoptysis
Naturopathy at hemoptysis

definition

Ultimately, any form of coughing that delivers blood through the airways is considered hemoptysis - regardless of the amount of blood. Therefore, the symptoms of hemoptysis are further differentiated in the art in the so-called hemoptysis, in which blood inclusions in the sputum (sputum) are observed, and hemoptysis, in which larger quantities of blood are coughed out directly.

symptoms

The different forms of the blood rush can be associated with different accompanying symptoms according to their causes, which are described below in connection with the respective diseases. However, it also threatens complaints directly as a result of blood loss in hemoptysis. If this goes unnoticed, for example, over an extended period of time, anemia can develop that leads to further impairments. High blood loss as it occurs in a hemoptysis, often causes a circulatory shock. Tachycardia, pale skin, cold sweats, breathing problems and disturbances of consciousness are possible consequences here. In the worst case, heavy blood loss can lead to death of the patient in a relatively short time.

causes

The spectrum of possible causes of hemoptysis ranges from acute lung injury and structural impairment of the bronchi to bacterial and viral respiratory infections to lung cancer. The symptoms may differ markedly according to the various causes, both in terms of the form of the blood-hens themselves and in terms of the observed concomitant symptoms. Therefore, a more detailed description of the possible causes of the blood rush and the respective concomitant symptoms follows.

Respiratory infections

The most common causes of hemoptysis are respiratory infections that cause severe bronchitis or pneumonia. In addition, coughing up blood is also part of the symptoms in special, rather rare diseases of the respiratory tract, such as pulmonary tuberculosis or legionellosis. This also applies to an infestation of the lungs with mold spores - the so-called aspergilloma.

bronchitis
A bronchitis is defined as inflammation of the bronchi (air-conducting airways between the trachea and alveoli) or the bronchial mucosa. This can be caused by various causes (for example, smoking), but usually viral infections trigger the complaints. The bronchitis is characterized by a strong, initially dry Hustreiz, which is accompanied by general complaints such as sore throat, hoarseness, body aches, headache, fever and runny nose. In severe forms threaten damage to the mucous membrane structures, which may be accompanied by mild mucosal bleeding and hemoptysis. From the acute bronchitis develops sometimes a chronic symptoms, such as the well-known smoker's cough, in which case the accompanying general symptoms are often absent or reduced to shortness of breath and poor performance.

lung infection
Are not the air-conducting structures of the lung affected by an inflammation, but the lung tissue involved in gas exchange, so in the art of pneumonia or pneumonia is mentioned. Possible triggers here are, for example, bacteria of the genus pneumococci, staphylococci or Haemophilus influenzae. Influenza viruses and adenoviruses can cause severe pneumonia. The same applies to various other viral strains, fungi and protozoa. The appearance of the pneumonia is usually quite similar to bronchitis and begins at first with severe coughing, difficulty breathing and shortness of breath. The sputum is purulent and in severe cases sometimes interspersed with blood inclusions. High fever, chills and chest pains are also part of the typical symptoms. Nonspecific symptoms such as headaches and body aches can also be added. All in all, pneumonia, especially for children, the elderly and immunocompromised patients, should be regarded as a very threatening disease, which in the worst case can be fatal.

tuberculosis
Pulmonary tuberculosis is a special form of bacterial respiratory tract infection in which inflammation forms in the affected lung tissue, which the organism tries to decapsulate. If this is not successful, unspecific symptoms such as tiredness, poor performance, mild fever and a persistent irritation of the lungs initially appear. Hemoptysis in the form of haemoptysis can only be observed in the case of particularly severe courses. Tuberculosis is generally not limited to the lungs, but can also affect various other organs. If the pathogens spread in the organism, this often leads to the death of the patients if treatment is not taken. A medical care of those affected is therefore urgently needed

Legionellosis / Legionnaire's disease
In the Legionellosis or the so-called legionnaires' disease is a bacterial infection, which is associated with severe pneumonia and can cause more than nonspecific complaints such as fever, chills, headache and irritable cough and coughing blood. Not infrequently, the Legionnaire's disease takes life-threatening proportions and due to the high infectiousness often local clusters of the diseases are observed. In addition, the bacteria can multiply in the absence of circulation and disinfection in various water reservoirs such as hot water systems, air conditioning systems, cooling towers or whirlpools. The consequence is also a greatly increased local occurrence of the infections. For example, several guests of a particular hotel or swimming pool are affected.

Cancer and hemoptysis

Both lung cancer and metastatic cancers of other organs that produce lung metastases can lead to destruction of lung tissue and coughing up blood. Thus, coughing up blood is a possible indication of lung cancer or bronchial carcinoma in advanced stages. Here, in the run-up to a longer period of time, usually unremarkable symptoms such as fever, coughing, a puncture in the chest and respiratory problems can be observed. Even lung metastases - ie cancer cells that have migrated from other organs, for example, via the blood system into the lungs - often behave inconspicuously in the early stages, but may later lead to hemoptysis. In addition to coughing, shortness of breath and chest pain, inexplicable weight loss is not uncommon.

Other causes of hemoptysis

Structural, non-infectious changes in the lung tissue as well as acute lung or thoracic injuries, but also diseases of the cardiovascular system and special autoimmune diseases (for example Goodpasture syndrome) are considered as possible further causes of hemoptysis.

bronchiectasis
Pathological, irreversible damage to the bronchi in the form of so-called bronchiectasis, as may occur, for example, as a result of neonatal diseases or cystic fibrosis, is occasionally associated with hemoptysis in particularly severe cases and / or subsequent infections. Generally, however, sufferers are more likely to suffer from severe coughing, which coughs up relatively large amounts of secretions. Remarkable symptom of bronchiectasis are also clearly visible swellings of the fingers and toes (drumstick fingers).

Cardiovascular disease
A possible cardiovascular cause of hemoptysis, for example, is valvular constriction (mitral valve stenosis). Blood backflow in the lungs often causes not only shortness of breath, but also severe forms of blood cough. Because mitral valve stenosis is associated with a significantly increased risk of fatal embolism, heart disease and pulmonary edema, valvular heart failure is an urgent need for medical attention. If the blood vessels of the lungs are blocked by a thrombus, this can also lead to hemoptysis. This so-called pulmonary embolism is associated with respiratory problems and an increased heart burden, which in turn can lead to heart failure in the worst case. In general, cardiovascular diseases, which are associated with a significant increase in pulmonary blood pressure (pulmonary hypertension), are also considered to be possible causes of hemoptysis. If the blood clotting is significantly reduced due to the intake of certain drugs or as a result of hemophilia, it can also lead to increased bleeding from tiny injuries within the lungs and thus also cause hemoptysis.

Goodpasture's syndrome
This very rare autoimmune disease is mainly directed against the blood vessels in the kidney cells and the lungs, although not all patients have pulmonary involvement. If there is a Goodpasture syndrome with pulmonary involvement, hemoptysis is one of the conspicuous concomitant symptoms. However, impairments of renal function, which can be associated, for example, with symptoms such as blood in the urine or protein precipitations in the urine (proteinuria), are primarily noticeable. Without treatment, the Goodpasture syndrome is usually fatal, but can be rescued by means of drug treatment and special blood purification, a large part of the patients.

Acute thorax injuries
If the lungs are injured by acute force on the chest, for example in a traffic or sports accident, and blood enters the lungs, coughing is a typical consequence. Since the lungs were usually damaged in such cases from the outside, the sufferers often have significant breathing problems and without medical care can use the death of the patient within a relatively short time.

Diagnosis and treatment of hemoptysis

The treatment of hemoptysis requires a therapy of the actual causes of this symptom, but there are only slight chances of recovery in individual diseases such as lung cancer. If larger quantities of blood are coughed up, in the first step a closure of the blood vessels is often necessary to stop the bleeding. This is done, for example, by means of a bronchial artery embolization, although the risk of recurrence of bleeding is relatively high and the actual cause of the blood rush remains untreated.

When the acute bleeding is stopped, the search for its causes follows. In the case of injuries due to external forces, this is usually relatively easy to complete and also pneumonia or bronchitis can usually be determined with little effort. If lung cancer is suspected, imaging techniques such as x-rays and computed tomography (CT) are of particular importance, but bronchoscopy (removal of bronchial tubes) may also be necessary to confirm the diagnosis. Imaging procedures and bronchoscopy are also the most important diagnostic tools for detecting bronchiectasis. In addition, heart valve defects can also be reliably identified by means of special X-ray images, CT and MRI (magnetic resonance tomography), whereby the echocardiography and the electrocardiogram can additionally provide important diagnostic information. In particular, echocardiography also serves to detect pulmonary hypertension.

Blood tests, for example, play an important role in the detection of Goodpasture syndrome or tuberculosis, with the latter also being able to perform a laboratory examination of coughing secretions (sputum or sputum) to ensure the diagnosis. In addition, an examination of the blood and sputum may provide evidence of other bacterial infections of the respiratory tract.

Once the cause of the blood cough has been identified, targeted therapy may begin, ranging from the treatment of expectorant and cough suppressant drugs, to antibiotic use in bacterial infectious diseases, to surgical removal of damaged lung tissue, and concomitant chemo and / or radiotherapy for lung cancer , Even with a heart valve failure, surgery may be required. This also applies to a pulmonary embolism, if the drug treatment with blood-thinning or anticoagulant drugs does not show the desired success. Ultimately, the selection of the appropriate treatment not only depends on the underlying disease, but in many cases is also largely determined by the stage of the disease at the time of diagnosis. In addition, the individual constitution of patients plays an essential role here.

Naturopathy at hemoptysis

Naturopathic treatment methods can only help with limited blood cough and especially in acute forms with exhalation of larger amounts of blood a purely naturopathic therapy is not an option, as the underlying bleeding can not be stopped with their help. On the other hand, if hemoptysis is caused, for example, by chronic bronchitis, there are certainly naturopathic treatment options that can be used concomitantly. Here, for example, promises measures that generally strengthen the immune system or even various home remedies for cough-assisting relief. Homeopathy also knows some remedies that may be helpful in respiratory infections or even pneumonia. However, these also develop only supportive character, a cure exclusively on their basis is not possible in the rule. (Fp)