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Shortness of breath and coughing up blood. Chest x-ray and blood test normal. What's wrong?

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Practicing since : 2003
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I went last week for a chest xray, ABG blood test and numerous other blood tests as I have been breathless and coughing blood occasionally. I got an all clear and was told my chest x-ray was crystal clear and all bloods were fine and attributed it to a chest infection that has been ongoing for months and my violent coughing could have ruptured something. Last week I began to feel better and the coughing blood subsided. I started exercising and taking my creatine supplements again last week and yesterday, I began to feel chesty again and the blood streaks began to appear again with coughing. Can creatine (supplement)inflame asthma and cause this, or should i go back to ER?
Posted Mon, 18 Feb 2013 in Lung and Chest disorders
Answered by Dr. Gyanshankar Mishra 2 hours later
Thanks for posting the query on XXXXXXX After going through the query, I would like to comment the following:

1. You seem to be a diagnosed case of asthma with GERD (gastro esophageal reflux disease) with associated depression.

2. In such a scenario, repeated episodes of hemoptysis needs to be evaluated in detail.

3. Creatine supplement is unlikely to cause hemoptysis. You need to increase your asthma medicines and a fresh course of antibiotics need to be started along with hemoptysis controlling medications. For 1 or 2 streaky episodes you can visit the regular opd in working hours however if the blood is more then a visit to ER is required.

4. Also a HRCT scan of the thorax needs to be done to rule out any underlying lung etiology like ABPA(Allergic broncho pulmonary aspergillosis) which could be a potential cause of hemoptysis( blood in sputum).

5. Get your pulmonary function tests done and your ashma medications can be titrated accordingly.

6. Thus you need to visit a pulmonologist and get yourself evaluated in detail as outlined above.

7. Yearly flu vaccine and 5 yearly pneumococcal vaccines will be helpful for you as the chances of secondary respiratory infections can be substantially decreased with them.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
Consultant Pulmonologist
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