Coughing Up Blood (Hemoptysis)
Article Sources
- 1. 'Learn About Cough.' American Lung Association, www.lung.org/lung-health-diseases/warning-signs-of-lung-disease/cough/learn-about-cough.
- 2. 'Coughing up Blood.' Mount Sinai Health System, www.mountsinai.org/health-library/symptoms/coughing-up-blood.
- 3. Coughing Up Blood By Rebecca Dezube, et al. 'Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
- 4. NHS Choices, NHS, www.nhs.uk/conditions/coughing-up-blood/.
- 5. 'Coughing up Blood Causes.' Mayo Clinic, Mayo Foundation for Medical Education and Research, 7 Apr. 2018, www.mayoclinic.org/symptoms/coughing-up-blood/basics/causes/sym-20050934.
- 6. Rull, Dr Gurvinder. 'Coughing Up Blood (Haemoptysis): Causes, Diagnosis and Treatment.' Patient.info, 23 Nov. 2017, patient.info/chest-lungs/cough-leaflet/coughing-up-blood-haemoptysis.
- 7. 'Coughing Up Blood (Hemoptysis): Causes, Tests & Diagnosis, Treatment.' Cleveland Clinic, my.clevelandclinic.org/health/symptoms/17696-coughing-up-blood.
Coughing is a reflex that helps the body expel germs, mucus, and dust from the throat and airways. Occasional coughing is normal and protects the body from irritants and disease-causing microorganisms.1‘Learn About Cough.’ American Lung Association, www.lung.org/lung-health-diseases/warning-signs-of-lung-disease/cough/learn-about-cough.
Sometimes blood is expelled during coughing. This is known as hemoptysis, and the blood comes from the respiratory tract. It's not blood that comes from the mouth, throat, or intestinal tract. Hemoptysis can occur as a result of a number of issues. In most cases, coughing up small amounts of blood isn't serious, but sometimes immediate medical attention is necessary.2‘Coughing up Blood.’ Mount Sinai Health System, www.mountsinai.org/health-library/symptoms/coughing-up-blood.,3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
1. Symptoms of Hemoptysis
Blood expelled during coughing often has a bright red or rust color and may appear as streaks in the sputum. It may look bubbly since it's mixed with mucus and air.2‘Coughing up Blood.’ Mount Sinai Health System, www.mountsinai.org/health-library/symptoms/coughing-up-blood. While hemoptysis may occur on its own, it's sometimes accompanied by other symptoms. These may include fever, chest pain, malaise, wheezing, and shortness of breath.6Rull, Dr Gurvinder. ‘Coughing Up Blood (Haemoptysis): Causes, Diagnosis and Treatment.’ Patient.info, 23 Nov. 2017, patient.info/chest-lungs/cough-leaflet/coughing-up-blood-haemoptysis.
Coughing up small amounts of blood may be alarming but it isn't always a medical threat. Coughed-up blood with a dark color and an appearance similar to coffee grounds may indicate a more serious problem that involves bleeding in the digestive system.4NHS Choices, NHS, www.nhs.uk/conditions/coughing-up-blood/.
2. Common Causes of Hemoptysis
Infection is the most frequent cause of coughing up blood, accounting for up to 90 percent of the cases. Bronchitis, bronchiectasis, and pneumonia are the leading causes of hemoptysis in adults. In children, lower respiratory tract infections and aspirated foreign objects often cause hemoptysis.3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
Any time a person experiences coughing over a long period of time, hemoptysis may develop. Blood from a nosebleed may also appear in saliva expelled while coughing.4NHS Choices, NHS, www.nhs.uk/conditions/coughing-up-blood/.
3. Less-Common Causes of Hemoptysis
Lung cancer that begins in the lungs may cause a person to cough up blood. However, if cancer has spread to the lungs from another part of the body, hemoptysis is less likely to occur.
Tuberculosis may also cause a person to cough up blood. A fungal infection of the lungs, called aspergillosis, is another possible culprit. Goodpasture syndrome, an autoimmune disorder, may be implicated in coughing up blood as well.3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
4. Causes of Massive of Hemoptysis
Massive hemoptysis occurs when a person coughs up more than a pint of blood within a 24-hour period. Lung cancer, bronchiectasis, and tuberculosis may cause this condition.3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
Other causes of hemoptysis include chronic obstructive pulmonary disease (COPD), cystic fibrosis, drug use, a lung abscess, and a pulmonary embolism. Trauma to the chest may also cause a person to cough up blood, as can mitral valve stenosis and parasitic infection.5‘Coughing up Blood Causes.’ Mayo Clinic, Mayo Foundation for Medical Education and Research, 7 Apr. 2018, www.mayoclinic.org/symptoms/coughing-up-blood/basics/causes/sym-20050934. Heart failure and lung collapse are some other possible causes of hemoptysis.1‘Learn About Cough.’ American Lung Association, www.lung.org/lung-health-diseases/warning-signs-of-lung-disease/cough/learn-about-cough.
5. Idiopathic Causes of Hemoptysis
Sometimes, despite thorough examination and testing, doctors can't determine the reason the person coughed up blood. This is known as idiopathic hemoptysis, and it occurs in one out of eight cases. Doctors diagnose idiopathic hemoptysis by ruling out other causes for coughing up blood.
Some idiopathic cases may be attributed to the bursting of a small blood vessel that bleeds for a short time, and the symptom may never arise again. Other idiopathic cases may have other causes that remain unidentified.6Rull, Dr Gurvinder. ‘Coughing Up Blood (Haemoptysis): Causes, Diagnosis and Treatment.’ Patient.info, 23 Nov. 2017, patient.info/chest-lungs/cough-leaflet/coughing-up-blood-haemoptysis.
6. Risk Factors for Hemoptysis
Long-time smokers, people who've been exposed to tuberculosis, and those with human immunodeficiency virus (HIV) infections are at greater risk of developing issues that cause hemoptysis. Coughing up blood may be indicative of more serious issues in those with cancer or previous blood clot incidents and people experiencing recent bed rest, surgery, or travel.
People taking immunosuppressive medications to combat such ailments as tuberculosis and fungal infections may be more likely to experience hemoptysis.3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
7. When to Get Medical Help
A person who coughs up a small amount of blood or blood-streaked sputum should make an appointment with a physician to evaluate the cause. In these cases, medical evaluation is important but not urgent.
Emergency medical care is in order if a person coughs up large amounts of blood. They should also seek emergency care if hemoptysis is accompanied by symptoms that include weakness or fatigue, shortness of breath, dizziness, and rapid heart rate.3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
8. Diagnosing the Cause of Hemoptysis
To determine the cause of hemoptysis, a health care provider reviews the person's medical history. They ask how long the person has been coughing up blood, how much blood is expelled, how often the incidents occur, and if anything triggers these events.
The provider conducts a physical examination, checking for fever, rapid heart rate, and shortness of breath. They check the heart and lungs and examine the legs for signs of puffiness that may indicate the presence of a blood clot.3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.
9. Tests for Hemoptysis
If hemoptysis is severe and persistent, physicians perform tests to determine the underlying cause. Tests may include a sputum culture to check for infection, and a chest X-ray, a CT scan, and bronchoscopy help identify other causes. To check for a pulmonary embolism, the physician may order a CT angiography, a lung perfusion scan, and pulmonary arteriography. A lung biopsy may also be done.
A urinalysis may be performed. Bloodwork may include a complete blood count and tests to assess clotting.3Coughing Up Blood By Rebecca Dezube, et al. ‘Coughing Up Blood - Lung and Airway Disorders. Merck Manuals Consumer Version, Merck Manuals, www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood.,7‘Coughing Up Blood (Hemoptysis): Causes, Tests & Diagnosis, Treatment.’ Cleveland Clinic, my.clevelandclinic.org/health/symptoms/17696-coughing-up-blood.
10. Treatment for Hemoptysis
Hemoptysis treatment depends on the cause. Sometimes the condition resolves on its own. If the cause is bleeding in the upper respiratory tract, the physician may use embolization or bronchoscopy to stop the bleeding.
If pneumonia or tuberculosis is causing hemoptysis, antibiotics may be prescribed. Steroids may be helpful for bleeding due to inflammation. If a tumor is the underlying issue, surgery and other cancer treatments may be necessary.7‘Coughing Up Blood (Hemoptysis): Causes, Tests & Diagnosis, Treatment.’ Cleveland Clinic, my.clevelandclinic.org/health/symptoms/17696-coughing-up-blood.
