Blood when coughing or coughing always indicates serious health problems, so in no case should this alarming sign be ignored. Why does this symptom develop? There are many reasons; they can be associated with lung diseases or indicate a dysfunction of other internal organs. Sometimes there is a single slight discharge of blood, which may appear if a capillary is damaged when coughing, but if coughing with blood recurs, you should immediately consult a doctor.
Types of hemoptysis
In medical practice, expectoration with blood is classified into several groups. The following types are distinguished:
- true hemoptysis is a condition characterized by the appearance of sputum with blood. The color of blood ranges from bright scarlet to brown. Along with this there is copious secretion of mucus from the bronchi;
- slight bleeding from the lungs - in this case, the patient coughs up sputum mixed with blood, the discharge is foamy, sometimes there is pure blood, there is no mucus. The total amount of daily secretion from the bronchi reaches 100 ml;
- moderate bleeding - the volume of expectorated blood reaches 500 ml;
- profuse bleeding is a serious condition accompanied by copious discharge of blood and mucus. The amount of secretion exceeds 500 ml.
Identifying the causes of the disease can be quite difficult. Sometimes this requires a long stay of a person in the hospital, a full examination with all the relevant tests.
There are several types of diseases that cause bleeding. These include harmless, congenital lung pathologies, common and rare diseases.
How dangerous is this?
The danger of this condition depends on the cause. If blood in the sputum is present in the form of several “bloody streaks,” then most likely this is simply expectoration of capillaries that have weakened due to illness or excessive physical exertion. If this is the first and only case, there is no danger to health, but you still need to consult a doctor. If these are episodic or systematically recurring attacks with the release of sputum colored in shades of red or brown, this is a reason for immediate consultation with a qualified pulmonologist. A lot often depends on the promptness of diagnosis and initiation of treatment.
Harmless reasons
Sometimes streaks of blood occur when coughing is caused by allergies or colds. This occurs due to mechanical damage to the capillary. This condition, as a rule, does not require treatment; the amount of blood released is very small. Some patients experience brownish sputum or small amounts of blood during therapy with anticoagulant medications. This happens due to the ability of drugs to thin the blood.
Sometimes a slight discharge of blood during coughing occurs due to damage to the capillaries
A slight discharge of blood is diagnosed when children cough. Due to the weakness of the capillaries, they can be damaged. In addition, the causes of such a symptom can be severe physical stress and emotional distress.
Important! If bleeding is isolated, do not sound the alarm and run to the doctor. If the symptom repeats several times and is combined with a general deterioration of the condition, you should immediately visit a specialist.
Symptoms of pathology development
Often symptoms help determine the diagnosis in the early stages of manifestation. The clinical picture of occurrence in all cases is usually the same: fatigue; constant weakness; dyspnea; dry cough, turning into cough with sputum; increased body temperature; pain in the thoracic and cervical regions; increased sweating; a sharp, unpleasant odor or taste that occurs in the mouth; weight loss; complete or partial loss of appetite; attacks of suffocation; decreased immunity; increase in colds; nausea followed by vomiting; the appearance of pus during coughing and vomiting; tachycardia; red-colored sputum; change in voice timbre; a sore throat; burning sensation in the chest.
Congenital pathologies of the respiratory system
Blood from the throat during expectoration is often a sign of congenital anomalies associated with the development of the bronchopulmonary system. There are several conditions in humans that are accompanied by bleeding from the lungs.
Cystic fibrosis
Cystic fibrosis of the pancreas or cystic fibrosis is accompanied by the secretion of mucus by the exocrine glands. As a result, secretion accumulates in the digestive organs, ducts of the mucous glands, and bronchi. As for the patient’s breathing, the patency of the bronchi is impaired, and purulent mucous contents accumulate in the organ. As a result of the development of bronchiectasis, the patient expectorates sputum with blood. In the absence of help, the organ becomes completely blocked, which can lead to death.
Rupture of a bronchial cyst
Bronchial cysts are diagnosed in both newborns and adult patients. The pathology is a neoplasm in the bronchi, which is often latent. Bleeding in this disease occurs due to rupture of the formation or its infection. At the same time, air accumulates in the bronchial cavity, the body temperature rises, the patient’s general well-being sharply worsens, weakness, irritability, and lack of appetite develop.
Rendu-Osler-Weber disease
Hemorrhagic telangiectasia or Randu-Osler-Weber disease is accompanied by frequent bleeding from dilated capillaries, is non-inflammatory in nature, and manifests itself in the form of spider veins and mesh formation on the skin. Telangiectasia affects various internal organs, including the respiratory system. Symptoms include frequent bleeding on the skin, anemia, and patients coughing up blood and mucus.
What causes hemoptysis in cancer?
95% of the blood enters the lungs through the pulmonary arteries, which have low pressure. Having reached the capillary bed, it gives off carbon dioxide and is saturated with oxygen. The remaining part of the blood (5%) reaches the lungs through the bronchial arteries, which have high pressure. It nourishes the respiratory organs and respiratory tract. Hemoptysis is characterized by bleeding from the bronchial arteries. The only exceptions are cases when the pulmonary arteries receive mechanical damage.
Hemoptysis in lung cancer develops against the background of malignant transformation of the epithelium of the respiratory tract. Blood loss is usually minimal. Massive bleeding develops only when the tumor grows into a large artery. This is a dangerous condition that can lead to death due to asphyxia or excessive blood loss.
Common lung diseases
Many patients ask why I cough up blood? This is explained by various lung diseases and their complications. These include tuberculosis, bronchitis, pneumonia and many other diseases. Let's look at each of them in more detail.
The most common cause of hemoptysis is lung disease
Fungal lung infection
Pulmonary candidiasis in the initial stages looks like a common cold, the patient coughs, and the general condition worsens. The cough may be dry or with copious sputum production. In the later stages, blood clots appear in the secretion, body temperature rises, breathing becomes difficult, and pain occurs in the chest.
Important! To diagnose the disease, sputum is examined for the presence of fungus, since X-rays can detect the disease only in the later stages.
Worm infestations
Often patients cough up blood due to the destruction of lung and bronchial tissue by parasites. The amount of blood can be insignificant or massive, depending on the degree of damage to the organ. The cough is often dry and paroxysmal. A person is worried about shortness of breath, allergic skin rashes, low-grade body temperature. Periodic headaches and dizziness appear.
Tuberculosis
One of the most common causes of bleeding when coughing is tuberculosis. Moreover, blood discharge is observed both during a cough and without it. Characteristic symptoms of the disease include:
- persistent increase in body temperature (38–39 degrees);
- weight loss;
- loss of appetite;
- heavy sweating during sleep;
- alopecia (hair loss);
- dry cough that lasts more than 3 weeks;
- hemoptysis.
These symptoms cannot be ignored; if they are detected, you must make an appointment with a doctor as soon as possible. Treatment of tuberculosis in the later stages requires a long time, often accompanied by serious condition and death of the patient.
Acute and chronic bronchitis
With the development of bronchitis, expectoration of sputum with small splashes of blood and pus occurs. This symptom is especially pronounced at the beginning of the disease, but even during this period it is not leading. Other manifestations of the disease include increased body temperature, general malaise, difficulty breathing, wheezing, dry cough, sweating, and chest pain. In the absence of proper treatment, bronchitis turns into pneumonia.
Lungs' cancer
The tumor in the lungs causes a severe cough, patients cough up copious amounts of mucus, pus mixed with blood. At the same time, body weight drops sharply, appetite decreases, shortness of breath, difficulty breathing, general weakness, and loss of ability to work develop. Treatment of pathology in the initial stages is carried out surgically. In later stages, the use of radiation and chemotherapy is necessary.
Lung cancer causes many dangerous symptoms, including bleeding when coughing
Pneumonia
Accompanied by hemoptysis is acute pneumonia, especially provoked by pathogens such as staphylococcus, Klebsiella, pseudomonas and others. The mucus has a rusty or brownish tint; scarlet blood clots are less common.
Other signs of pneumonia include:
- a sharp increase in body temperature, sometimes up to 40 degrees;
- weakness;
- severe suffocating cough;
- headache;
- loss of appetite;
- sometimes loss of consciousness.
The condition requires immediate treatment. Therapy with antibiotics and other medications is used.
Pulmonary infarction
Pulmonary infarction is a condition in a patient in which ischemia of a certain part of the organ occurs due to embolism or thrombus of the pulmonary artery. A person complains that he has pain in the chest and develops a dry cough. Unpleasant sensations intensify with physical activity, bending, turning. Symptoms of the disease in 50% of patients include coughing up blood. The sputum has a rusty tint, and there are insignificant spots of blood. In some cases, heavy pulmonary hemorrhage is diagnosed.
Pulmonary abscess
A lung abscess is characterized by the development of an inflammatory process in the tissues of the organ, which is why the formation of purulent-necrotic cavities is observed in the lungs. When coughing up, the sputum has bright spots of blood and is accompanied by an unpleasant putrid odor. The amount of secretion sometimes reaches 1 liter. The patient experiences pain in the sternum, loss of appetite, and loss of body weight. The abscess causes a sharp increase in body temperature, weakness, and apathy.
Pathologies of the cardiovascular system
In addition to lung diseases, heart and vascular diseases can provoke hemoptysis. These include:
- pulmonary edema due to decreased pumping function of the heart. The condition causes severe shortness of breath, foamy discharge mixed with blood;
- Mitral stenosis is a disease that occurs due to disruption of blood flow due to narrowing of the mitral orifice. In this case, the patient experiences a severe cough with blood, especially during physical exertion, shortness of breath, and a general deterioration in health;
- Aortic aneurysm is another cause of pulmonary hemorrhage. Compression of the lung leads to atelectasis and causes the development of pneumonia. The patient develops a cough mixed with blood and suffocation. The condition is serious and often ends in the death of the patient.
Some heart diseases cause pulmonary hemorrhage
Pathologies of the heart and blood vessels are often indicated by the release of blood without coughing. If you notice this symptom, you should definitely make an appointment with a doctor.
Important! The lungs of a healthy person produce about 50 ml of mucus per day. This is an absolutely normal physiological process, indicating good functioning of the organ.
How to treat coughing up blood?
With moderate symptoms, and if this condition occurs during a cold, no special treatment is needed.
If treatment is necessary, the doctor will treat the condition that is causing the coughing up of blood. Your doctor can stop bleeding with the following treatment:
- Prescribe a cough medicine that eliminates cough;
- Prescribe antibiotics for bronchiectasis or lung infection;
- Carry out a special hemostatic procedure during bronchoscopy
- Treat PE if it is causing hemoptysis
Diagnostics
To identify the causes of blood discharge during expectoration, a comprehensive examination is carried out, including the following methods:
- X-ray. Using this type of study, it is possible to determine lung cancer, pulmonary embolism, inflammation, fungal and helminthic lesions of the organ;
- computed tomography. The method helps to assess the condition of the lungs and bronchi, determine pathological changes in their structure;
- blood analysis. Laboratory blood tests help identify the inflammatory process in the body;
- sputum analysis. Carried out to identify infectious agents;
- electrocardiography. This instrumental study reveals a disturbance in the functioning of the heart;
- endoscopy and other methods of examining the digestive organs.
Symptoms for various diseases accompanied by hemoptysis are very similar. You should not try to make a diagnosis yourself. Only a doctor can do this.
First aid for pulmonary hemorrhage
What to do when a person has excessive bleeding from the lungs? If this condition develops, the patient should be hospitalized immediately. After calling an ambulance, you must do the following:
- Help the patient assume a semi-sitting position.
- The head should be raised.
- A person should spit out the secreted blood and should never hold it or swallow it.
- If the situation allows, you need to give the patient a cold drink or swallow some ice.
- When the patient is unconscious, his head must be turned to the side so that he does not choke.
After the ambulance arrives, doctors need to be informed under what circumstances the bleeding developed. This will help in further diagnosis.
How is the treatment carried out?
The method of therapy always depends on the type of disease. For acute bronchitis, treatment consists of rest, drinking plenty of fluids, using mucolytic drugs, drugs that help remove sputum, and non-steroidal anti-inflammatory drugs. To remove mucus from the lungs and bronchi, the following drugs are prescribed:
- Pectolvan;
- Bromhexine;
- Ambrobene;
- Ambroxol and others.
For severe pain in the chest, compresses that have a warming effect are used. Physiotherapy is often used. With the development of bronchial obstruction, drugs are prescribed that expand the lumen of the organ. For bronchitis caused by a viral infection, antiviral drugs are indicated (Viferon, Amiksin, Amizon and others).
Treatment of hemoptysis is carried out depending on the cause of the development of this symptom.
Symptomatic treatment involves the use of bronchodilators (Ascoril, Beroteka, Bronholitina), mucolytics (Mukobene, Muconex, Ambroxol), expectorants. Oncological formation in the lungs, detected in the early stages, requires surgical intervention. In combination with surgery, radiation and chemotherapy are prescribed. Chemotherapy is used in cases where there are serious contraindications to surgery. At later stages, when metastases develop, palliative treatment is carried out. Its essence is to alleviate symptoms and prolong the patient’s life.
Prevention
The main methods of preventing hemoptysis are preventing the pathologies that cause it. Quitting smoking, maintaining a healthy lifestyle, regular exercise, and timely treatment of colds are important.
Sources:
- Earwood JS, Thompson TD. Hemoptysis: evaluation and management // Am Fam Physician. 2015 Feb 15;91(4):243-9.
- Ittrich H, Bockhorn M, Klose H, Simon M. The Diagnosis and Treatment of Hemoptysis // The Diagnosis and Treatment of Hemoptysis.Dtsch Arztebl Int. 2021 Jun 5;114(21):371-381. doi: 10.3238/arztebl.2017.0371.
- K. Krenev, I am Kabysh, O Yudin. Difficult patient or patient with hemoptysis // Sciences of Europe, 2021, No. 48, pp. 17-22
