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Health

Coughing up blood

, medical expert
Last reviewed: 17.10.2021
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Coughing up with the blood is an alarming symptom, indicating various diseases - from simple enough to serious, sometimes threatening not only health, but also human life. Cough, accompanied by sputum, is considered productive, as it helps to eliminate the infected with microbes, viruses of bronchial secretions. However, a cough with blood can be a sign of a pathological process in the internal organs, accompanied by bleeding.

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What causes coughing with blood?

Bronchitis, in any form - acute or chronic. If a cough with blood is accompanied by a high fever, most likely the inflammation of the mucous epithelial membrane of the bronchial tree proceeds acutely. The chronic form of bronchitis is characterized by a prolonged period of the cough symptom, sometimes more than three to four months, the temperature does not usually increase, and the blood in the sputum is present in the form of small inclusions, often combined with pus. 

Bronchiectasis or bronchoectatic disease is a purulent process in deformed bronchi accompanied by persistent long-term cough. The bronchial secretion contains small veins with pus and blood. Also, endobronchitis may be accompanied by subfebrile fever, shortness of breath and general weakness 

Cardiopathology - rheumatism of valves, vices. Cough with blood is caused by changes in blood circulation and stagnant respiratory symptoms. In the lungs, blood stasis (hypertension) also forms, which leads to shortness of breath and sputum discharge with blood splashes. 

Inflammatory process in the lungs, pneumonia. The first symptoms of pneumonia can be hyperthermia (fever), pain in the chest (sternum or back), later they are coughing with blood. 

Traumatic injuries of trachea, bronchi. Trauma can be associated with both a household cause (stroke) and with the inevitable microdamaging of the mucous membranes during diagnostic procedures - biopsy, bronchoscopy. Coughing with blood in such cases is not a threatening symptom, it is considered an acceptable side effect of the surgical method of investigation. 

Diseases of the gastrointestinal tract, localized in the digestive tract, its upper zones - ulcerative esophagus, erosive damage to the duodenum, stomach ulcer. Cough with blood is often confused with emetic secretions, typical for ulcerative lesions of the digestive system. Blood in the secretions is present in the form of clots of a dark, reddish hue. 

Cystic fibrosis is a serious disease associated with a genetic defect resulting in pathological accumulation of mucus and sputum. A typical symptom of cystic fibrosis is persistent cough, often accompanied by secretions with clots of mucus and blood. 

Oncological pathology of the lungs. Coughing with blood is one of the most characteristic signs of lung cancer. Bloody filamentous inclusions in the discharge (sputum), increased sweating, shortness of breath, a gradual decrease in body weight are threatening signs of oncoprocess. 

Purulent abscess of the lungs is most often the result of prolonged pneumonia. Coughing with blood, regular body temperature jumps, excessive sweating, soreness in the sternum, sputum discharge with pus, characteristic unpleasant odor are all symptoms of a stagnant purulent process. 

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

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

Who to contact?

When does a cough with blood require the help of a doctor?

  • Cough, accompanied by abundant secretions with blood. 
  • Cough with blood, combined with a sharp decrease in weight. 
  • Persistent cough, paroxysmal and regular cough with bloody impregnations. 
  • Dyspnoea in a state of immobility, at rest. 
  • Severe pain in the chest, accompanied by a cough. 
  • Abundant sputum discharge with bright red blood (sign of pulmonary hemorrhage). Emergency medical care is needed.

How is coughing with blood diagnosed?

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

  • Radiographic examination of the chest, which examines the condition of the pulmonary system and heart. Any darkening in the picture is a symptom of the pathological process, which can be caused by oncology, pneumonia, purulent abscesses. If the shape of the shadow pattern of the heart changes, there is an occasion to continue more thorough cardiac studies to confirm or eliminate the valve defect. 
  • Bronchoscopic examination is intended to clarify the diagnosis of lung cancer, bronchiectasis. The lumen of the bronchial tree is examined for the detection of tumors or pathological extensions. 
  • Coughing up the blood can signal a number of serious diseases that are diagnosed by computed tomography. 
  • Bacterial examination of secretions, sputum allows to identify the causative agent of the inflammatory process in the broncho-pulmonary system. A similar method is used to determine mycobacteria - Koch's rods with suspicion of tuberculosis. 
  • If suspected of cystic fibrosis, a symptom of which is also a cough with blood, an exudate is analyzed to determine the level of chlorine metabolism. 
  • The standard study is UAC - a general blood test that shows changes in quantitative leukocyte counts, determines the rate of erythrocyte sedimentation (ESR). OAK helps to clarify the form of the course of the disease - chronic or acute. 
  • It is mandatory to study the activity of coagulability of blood - coagulogram. 
  • If heart disease is suspected, ultrasound of the heart and cardiographic examination are prescribed. 
  • In clinical manifestations of the ulcerative process of the gastrointestinal tract, PHEGS is prescribed - gastroscopy, in which the upper zone of the digestive system is examined.

How to treat a cough with blood?

The therapeutic strategy for treating a cough symptom, accompanied by the spitting out of the sputum with blood, depends on the exact diagnosis, the degree of severity of the pathological process. Since coughing with blood is not an independent disease, but is considered a clinical manifestation of the disease, cough treatment, as a rule, is symptomatic. In cases of inflammatory processes, complex antibacterial therapy is prescribed, if the etiology of the disease is viral, antiviral drugs and immunomodulating agents are prescribed that can activate the immune system and regulate the humoral processes. In severe, pathological situations, such as lung cancer, purulent abscess, an open stomach ulcer, without surgical intervention is indispensable. If a cough with blood is one of the symptoms of cystic fibrosis, then it is controlled with the help of lifelong reception of mucolytic drugs. To date, cystic fibrosis is considered an incurable disease, however, provided that the drug is regularly consumed, besides mucolytics, there are enzymatic agents, antibiotics, hepatoprotectors, adherence to a special diet and constant performance of respiratory exercises, the patients live quite a full and high-quality life.

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