Coughing up blood is an alarming symptom indicating various diseases – from fairly simple to serious, sometimes threatening not only health, but also human life. A cough accompanied by the discharge of sputum is considered productive, as it helps to remove bronchial secretions infected with microbes and viruses. However, coughing up blood may be a sign of a pathological process in the internal organs, accompanied by bleeding.

What causes coughing up blood

Bronchitis, in any form – acute or chronic. If a cough with blood is accompanied by a high temperature, most likely the inflammation of the mucous membrane of the epithelial lining of the bronchial tree is acute. The chronic form of bronchitis is characterized by a long period of cough symptoms, sometimes more than three to four months, the temperature, as a rule, does not rise, and blood in the sputum is present in the form of small patches, often combined with pus.

Bronchiectasis or bronchiectasis is a purulent process in deformed bronchi, accompanied by a persistent, prolonged cough. Bronchial secretions contain small streaks of pus and blood. Endobronchitis may also be accompanied by low-grade fever, shortness of breath and general weakness.

Cardiopathology – valve rheumatism, defects. Coughing up blood is caused by changes in blood circulation and respiratory congestion. Blood stagnation (hypertension) also forms in the lungs, which leads to shortness of breath and the discharge of sputum interspersed with blood.

Inflammatory process in the lungs, pneumonia. The first symptoms of pneumonia may be hyperthermia (increased body temperature), pain in the chest area (sternum or back), later followed by coughing up blood.

Traumatic injuries to the trachea and bronchi. Trauma can be associated both with a domestic cause (impact) and with inevitable microdamage to the mucous membranes during diagnostic procedures – biopsy, bronchoscopy. Coughing up blood in such cases is not a threatening symptom; it is considered an acceptable side effect of the surgical method of examination.

Diseases of the gastrointestinal tract, localized in the digestive tract and its upper zones – ulcerative processes of the esophagus, erosive damage to the duodenum, stomach ulcers. Coughing up blood is often confused with vomiting, which is typical of ulcerative lesions of the digestive system. Blood in the discharge is present in the form of dark, reddish clots.

Cystic fibrosis is a serious disease associated with a gene defect that leads to an abnormal accumulation of mucus and phlegm. A typical symptom of cystic fibrosis is a persistent cough, often accompanied by a discharge containing clots of mucus and blood.

Oncological pathology of the lungs. Coughing up blood is one of the most characteristic signs of lung cancer. Bloody threadlike patches in the discharge (sputum), increased sweating, shortness of breath, and gradual loss of body weight are ominous signs of an oncological process.

A purulent lung abscess is most often a consequence of prolonged pneumonia. Coughing with blood, regular fluctuations in body temperature, increased sweating, pain in the sternum, discharge of sputum with pus, a characteristic unpleasant odor – all these are symptoms of a stagnant purulent process.

Tuberculosis, which rarely manifests clinical signs at the first stage of development, can be suspected by a cough symptom with the discharge of blood-streaked sputum.

Blockage or blockage of the arteries of the lungs – embolism. Most often, embolism is not an independent syndrome; it develops as a result of venous insufficiency due to vascular or hemolytic pathologies (thrombophlebitis, thrombosis), or surgical intervention. Embolism develops rapidly and is accompanied by acute chest pain, then hemoptysis.

When coughing up blood requires doctor’s help

  • Cough accompanied by copious amounts of bloody discharge
  • Coughing up blood accompanied by sudden weight loss
  • Persistent cough, paroxysmal and regular cough with bloody patches
  • Shortness of breath when immobile, at rest
  • Severe chest pain accompanied by cough
  • Copious sputum with bright red blood (a sign of pulmonary hemorrhage). Emergency medical attention required

How is coughing up blood diagnosed?

At the first warning signs, which are any manifestations of blood in the sputum, whether minor or heavy, you should seek medical help. The following methods are used as diagnostic measures:

  • A chest x-ray that examines the condition of the pulmonary system and heart. Any darkening in the image is a symptom of a pathological process, the cause of which may be oncology, pneumonia, purulent abscesses. If the shape of the shadow pattern of the heart changes, there is a reason to continue more thorough cardiac studies to confirm or exclude valve disease.
  • Bronchoscopic examination is intended to clarify the diagnosis of lung cancer and bronchiectasis. The lumen of the bronchial tree is examined to identify tumors or pathological expansions.
  • Coughing up blood can signal a number of serious illnesses that can be diagnosed using a CT scan.
  • Bacterial examination of secretions and sputum allows us to identify the causative agent of the inflammatory process in the bronchopulmonary system. A similar method is used to determine mycobacteria – Koch bacilli when tuberculosis is suspected.
  • If cystic fibrosis is suspected, a symptom of which is also coughing up blood, the effusion is analyzed to determine the level of chlorine exchange.
  • The standard test is the CBC – a general blood test, which shows changes in the quantitative indicators of leukocytes and determines the erythrocyte sedimentation rate (ESR). OAC helps to clarify the form of the disease – chronic or acute.
  • A study of blood clotting activity – a coagulogram – is mandatory.
  • If a heart defect is suspected, a cardiac ultrasound and cardiographic examination are prescribed.
  • In case of clinical manifestations of an ulcerative process of the gastrointestinal tract, FEGDS is prescribed – gastroscopy, during which the upper zone of the digestive system is examined.

How to treat coughing up blood

The therapeutic strategy for treating a cough symptom accompanied by the discharge of sputum with blood depends on the exact diagnosis and the severity of the pathological process. Since coughing up blood is not an independent disease, but is considered a clinical manifestation of the disease, treatment of cough is usually symptomatic. In cases of inflammatory processes, complex antibacterial therapy is prescribed, if the etiology of the disease is viral in nature, antiviral drugs and immunomodulatory agents are prescribed that can activate the immune system and regulate humoral processes. In severe, pathological situations, such as lung cancer, purulent abscess, open gastric ulcer, surgery cannot be avoided. If coughing up blood is one of the symptoms of cystic fibrosis, it is controlled with lifelong use of mucolytic drugs. Today, cystic fibrosis is considered an incurable disease, however, subject to regular use of a complex of drugs, which, in addition to mucolytics, includes enzymatic agents, antibiotics, hepatoprotectors, adherence to a special diet and constant breathing exercises, patients live a fairly full and high-quality life.

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