Exercise Induced Pulmonary Hemorrhage - Clinical Signs

Clinical Signs

Epistaxis is diagnosed when blood is visible at either or both nostrils during or following exercise. To confirm whether the blood is from the upper or lower airway requires further examination by endoscopy, although in some cases it is not possible to determine the location. In the majority of epistaxis cases, the blood originates from the lung. Epistaxis during or following exercise can less commonly occur as a result of upper airway hemorrhage, for example following head trauma. Poor athletic performance, frequent swallowing and coughing in the immediate post-exercise recovery period may be suggestive of EIPH. But, a definitive diagnosis can only be made by endoscopic examination of the trachea. In the case where no blood is visible in the trachea, EIPH in the small airways may still be present and can be confirmed by a broncho-alveolar lavage.