Daijiworld Media Network - Mumbai
Mumbai, Sep 18: Spotting blood in your cough can be alarming, and doctors warn that the symptom must never be ignored. Medically known as haemoptysis, the condition may range from a simple infection to serious, life-threatening lung disease.
According to a 2022 study published in the Indian Journal of Mycology, tuberculosis accounts for nearly 60% of haemoptysis cases in India. Other common causes include aspergilloma, bronchiectasis, pneumonia, and lung cancer. Another research published in BMC Pulmonary Medicine revealed that untreated massive haemoptysis carries a mortality rate of more than 50%, making it one of the most dangerous respiratory emergencies.
What is haemoptysis?
Haemoptysis refers to coughing up blood that originates from the lungs or airways. The blood is usually bright red, frothy, or mixed with mucus. It differs from bleeding that starts in the stomach or nose.
How serious can it get?
Doctors classify haemoptysis into mild, moderate, or massive.
• Massive haemoptysis involves more than 200-600 ml of blood in 24 hours or any bleed that obstructs breathing.
• Mortality in massive, uncontrolled cases is above 50%.
• Even moderate bleeding can recur if the underlying cause is untreated.
Main causes of haemoptysis
• Tuberculosis (TB): Still the leading global cause, responsible for majority of cases in India.
• Bronchiectasis: Fragile airways due to repeated infections often trigger massive haemoptysis.
• Respiratory infections: Pneumonia and bronchitis may cause streaks of blood.
• Lung cancer: Tumours can erode vessels, and in many cases, haemoptysis is the first warning sign.
• Other causes: Pulmonary embolism, fungal infections (aspergilloma), autoimmune diseases, and side-effects of blood thinners.
Red-flag warning signs
Doctors urge patients to seek immediate medical help if they experience:
• Large amounts of blood in cough
• Repeated bleeding for days
• Shortness of breath, dizziness or chest pain
• Fever, night sweats or unexplained weight loss
• Past history of TB, smoking, lung disease, or anticoagulant use
How is it diagnosed?
• Chest X-rays and CT scans for infections, tumours, or scarring
• Bronchoscopy to view airways and sometimes control bleeding
• Blood and sputum tests for TB or infections
• Specialised tests for autoimmune or vascular disorders
Treatment options
• Mild cases: Antibiotics, adjustment of anticoagulants, quitting smoking
• Severe cases: Bronchial artery embolisation (success rate above 90%), surgery to remove tumours or aspergilloma, airway support
• Underlying causes: TB treatment, antifungal drugs, or cancer therapy depending on the diagnosis
Research insights
• Tuberculosis remains the leading cause of haemoptysis in India
• Bronchiectasis is the most common trigger for massive bleeding
• Mortality exceeds 50% if untreated
• Bronchial artery embolisation has emerged as a highly effective intervention
Doctors caution that haemoptysis must never be taken lightly. Whether it is just a streak of blood or a mouthful, timely medical evaluation can be lifesaving.