Coughing Up Blood
Coughing up blood, also called hemoptysis, can be alarming and should not be ignored. Blood appears in the mucus or spit you cough up, and causes can range from minor infections to serious health conditions. In many cases, the blood comes from the lungs or airways, but it can also originate from other areas, such as the stomach.
Common causes include infections like bronchitis or pneumonia, chronic conditions such as COPD, injury to the airways, or lung cancer. Smoking, severe coughing, or inhaling foreign objects can also trigger this symptom. Even if the cause is minor, you should see a healthcare provider to determine where the blood is coming from and why.
Definition Of Symptom
Coughing up blood, known as hemoptysis, means that blood comes out of the mouth along with mucus or phlegm during a cough. This blood can appear as streaks in spit, or as larger amounts mixed with mucus. Sometimes, the blood looks bright red and frothy, while other times it may look darker and mixed with thick mucus.
Hemoptysis can start suddenly or develop slowly over time. People may notice blood in their tissue or in what they cough up, which may be alarming. Not all cases involve a large amount of blood. Even a small amount of blood in the phlegm can signal irritation or minor injury within the airways. Common features of hemoptysis include:
- Blood mixed with mucus or phlegm.
- Cough producing streaks of blood.
- Sometimes pink, red, or rust-colored spit.
| Appearance | Description |
|---|---|
| Bright red blood | Usually from the lungs or airways. |
| Frothy phlegm | Indicates air mixed with blood from the lungs. |
| Dark, sticky blood | May come from deeper in the lungs or stomach. |
Possible Causes/Disease Conditions
Coughing up blood can happen for many reasons. Some causes are mild, while others are more serious and need immediate care. Common causes include:
- Bronchitis (both acute and chronic)
- Pneumonia
- Respiratory infections like viral or bacterial illnesses
- Chronic Obstructive Pulmonary Disease (COPD)
- Bronchiectasis (long-term damage of the airways)
Other conditions that may cause hemoptysis:
- Lung cancer
- Cystic fibrosis
- Pulmonary embolism (blood clot in the lungs)
- Tuberculosis (TB)
- Lung abscess (pocket of pus in the lung)
- Fungal infections in the lungs
Some rare or less common causes:
- Heart failure can cause blood to back up in the lungs, leading to pulmonary edema.
- Autoimmune conditions like granulomatosis with polyangiitis.
- Foreign body in the airway.
- Pulmonary edema (fluid buildup in the lungs).
- Cancer elsewhere in the chest or airways.
| Cause/Disease | Type |
|---|---|
| Bronchitis | Respiratory infection |
| Bronchiectasis | Lung disease |
| Pneumonia | Lung infection |
| Cystic Fibrosis | Genetic lung disease |
| Lung Cancer | Cancer |
| Pulmonary Embolism | Blood clot |
| Tuberculosis (TB) | Bacterial infection |
| Lung Abscess | Infection |
| COPD | Chronic lung disease |
| Heart Failure | Cardiac condition |
Other Non-Disease Causes
Coughing up blood is not always linked to disease. Some non-disease causes can also lead to this symptom.
- Injury to the airways often causes blood in the saliva or mucus. Hard coughing from a chronic cough can injure small blood vessels. This is more likely if chest pain or shortness of breath is also present.
- Medical procedures and surgery can cause temporary bleeding in the lungs or throat. For example, a recent lung biopsy or throat surgery might lead to minor bleeding. This usually resolves on its own unless fever, fatigue, or difficulty breathing start.
- Certain medications and drug use can increase the risk. People taking blood thinners may notice blood if a blood vessel in the lungs or throat breaks. Recreational drug use, such as smoking or inhaling substances, can also damage the airway lining.
- Environmental factors may play a role. Breathing in irritants like smoke, dust, or chemicals can cause irritation, making it easier to cough up small amounts of blood.
- Rare situations, such as endometriosis affecting the lungs, can also cause bleeding during the menstrual cycle. Other possible symptoms might include dizziness or lightheadedness.
Quick Reference Table
| Non-Disease Cause | Signs to Watch For | Other Related Symptoms |
|---|---|---|
| Airway Injury | Bloody mucus | Chest pain, shortness of breath |
| Surgery/Medical Procedure | Fresh blood | Fever, fatigue, difficulty breathing |
| Blood Thinners/Drug Use | Repeated episodes | Dizziness, lightheadedness |
| Environmental Irritants | Small streaks of blood | Chronic cough |
| Lung Endometriosis | Blood during periods | Weight loss, fatigue |
How It Causes The Symptom
Coughing up blood usually happens when blood vessels in the airways or lungs get damaged. Small tears or irritation in these blood vessels can cause bleeding, which mixes with mucus and gets coughed up. Infections like bronchitis or pneumonia can make airways swollen and fragile, leading to damage. Chronic lung diseases, such as bronchiectasis or COPD, weaken airway walls and raise the risk of bleeding.
Lung cancer or tumors can erode nearby tissue and blood vessels, causing more severe bleeding. Clots blocking blood flow, as in pulmonary embolism, can also rupture vessels in the lungs. Doctors use tests such as a chest X-ray or a CT scan to see what is happening inside the chest. These images help spot infections, tumors, or clots.
A complete blood count (CBC) checks for anemia or signs of infection. Sometimes, doctors use a thin, flexible tube to look at and treat the inside of the airways. Treatment depends on the cause. Infections may be treated with medicine. If cancer is the reason, doctors may use treatments like chemotherapy. In emergencies, the focus is on stopping the bleeding and keeping the airways clear.
Possible Complications
Coughing up blood can lead to several health problems, depending on the cause and amount of blood. Short-term complications may include:
- Breathing trouble if blood clogs the airways
- Low oxygen levels
- Feeling faint or dizzy
Serious complications can happen if the bleeding is heavy or does not stop. In some cases, a person may need emergency help due to large blood loss or choking. There is also a risk of infection, especially if the bleeding is caused by a lung infection. Lung tissue can become damaged over time, leading to further problems.
When To Seek Medical Attention
Get medical help if you cough up blood, even if it seems minor. Small amounts may not be urgent, but checking with a doctor is always best. Call emergency services or go to the hospital if:
- You are coughing up a lot of blood.
- The bleeding does not stop.
- You have chest pain or trouble breathing.
- Blood appears in your urine or stools.
- You also have a fever, feel weak, or lose weight suddenly.
If you cough up blood after a chest injury, seek care right away. This can be a sign of a serious problem. Use the table below to help decide when to seek help:
| Situation | Action |
|---|---|
| Small dot or streak of blood | Contact a doctor soon |
| Large amount or ongoing bleeding | Call emergency services |
| With chest pain, fever, or shortness of breath | Call emergency services |
| After an accident or injury | Go to the hospital |
