Hemoptysis (coughing up blood) is a complication of pulmonary hypertension that sometimes triggers initial diagnosis of the disease. In my case, I had massive hemoptysis 16 years into my diagnosis and treatment. The episode prompted my doctors to list me for a heart-lung transplant.
I didn’t see it coming: that afternoon I flew into Seattle from San Francisco, went to a cafe and did some work. In the evening I walked about a mile to and from dinner without issue. At midnight I awoke on my friend’s couch unable to stop coughing. I coughed something up into my hand and ran to the bathroom when I saw that it was blood.
As I coughed more and more blood into the toilet, my friend got up from the other room and called 9-1-1. She brought me the portable oxygen concentrator I’d left behind when I raced to the bathroom. I tried to stay calm and breathe through my nose, taking in more oxygen while I waited for the paramedics to arrive.
Hemoptysis isn’t always an emergency room situation. For example, you might cough up a small amount of blood that you swallowed during a nosebleed. The seriousness of the condition depends on the amount of blood and the length of time the patient spends coughing up blood. I coughed up about a cup of bright red blood and continued to have smaller episodes for the next couple days. Regardless of the seriousness of the event, with a PH diagnosis one should always contact a physician for further testing.
Treatment for hemoptysis will also vary. Bronchial artery embolization, a minimally invasive endovascular technique, has become the method of choice for treating massive and recurrent hemoptysis. Anticoagulant medication may be reduced to prevent further episodes.
Have you ever coughed up blood? How did you and your team manage the situation?
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