Overview Of Coughing Up Blood
Coughing up blood can be a result of a number of lung conditions. The blood can range from pink to red and may have mucus mixed in. The formal name for coughing up blood is hemoptysis. Any amount of coughing up blood can certainly be alarming, but coughing up mucus with a little blood is not typically serious. If you are coughing up an alarming amount of blood or at a frequent rate, then you will need to see a doctor immediately.
What Infections Cause Haemoptysis
Tuberculosis can cause coughing up blood while other upper respiratory infections lead to conditions which haemoptysis is a symptom of. The most common conditions are bronchitis, bronchiectasis and a severe form of pneumonia called necrotising pneumonia.
Common causes of coughing up blood in children are lower respiratory tract infections and aspiration of foreign bodies. This is where food or other swallowed objects can get stuck in the oesophagus. They can sometimes cause perforation, which can lead to bleeding.
Coughing up blood should always be medically attended to. It’s very important to arrange an appointment with your GP if you experience the following:
- Coughing up more than a few teaspoons of blood
- There’s blood in your urine or stools
- A loss of appetite or have unexplained weight loss alongside haemoptysis
- Chest pain, dizziness, fever or light-headedness or shortness of breath that gets worse.
What Medications Can Cause Hemoptysis
Hemoptysis can be more likely when people are on anticoagulants. These medications are commonly referred to as blood thinners, They may be given when people have had a blood clot or are at risk of getting one.
Examples of blood thinning medications include:
When people take these medications, they have a higher risk of bleeding. This bleeding can include hemoptysis.
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If You Cough Up A Small Amount Of Blood
Often the blood is mixed in with spit . This is common. Sometimes there is a small amount of blood mixed with sputum each time you cough. Sometimes it is a one-off small amount of blood. However, if you ever cough up blood and do not know the reason for it, no matter how small the amount of blood, you should see your doctor soon. Coughing up blood is a symptom which may indicate a serious disease. As a general rule, the earlier a serious problem is diagnosed, the better the chance that treatment may improve the outlook .
Other symptoms may occur at the same time as coughing up blood. For example, cough, chest pain, breathlessness, a high temperature , feeling unwell, wheeze or other lung symptoms. The presence and type of other symptoms may help to point to a cause of the bleeding. Sometimes there are no other symptoms at first.
When To See A Doctor About Coughing Up Blood
Coughing up blood is very serious. You will want to see a physician as soon as you believe you are coughing up blood at an alarming rate. There may be something else happening and may require immediate medical attention. The most common cause for coughing up blood is bronchitis, which will usually get better on its own, but sometimes this can be very serious too. Be on the lookout for these symptoms as well: chest pain, shortness of breath, soaking sweats at night, fever at above 101 degrees, weight loss, etc. You will likely be admitted into the hospital until the cause of the coughing up blood is discovered.
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Diagnosing The Cause Of Hemoptysis At Dignity Health
Doctors usually rely on a physical exam and medical tests, including chest X-ray, to diagnose the cause of hemoptysis. The doctor in charge of your care will likely order lab tests on the sputum you cough up to look for signs of an infection. You may also need a test called a bronchoscopy to examine the airways. After your diagnosis, your doctor will recommend treatment of the cause, such as antibiotics for bacterial bronchitis or pneumonia. For coughs with large quantities of blood, you may need to be treated in the intensive care unit of our hospital until your condition stabilizes. Dignity Health – St. Rose Dominican offers emergency diagnosis and treatment options for patients with hemoptysis in Las Vegas and Henderson, NV.
You Can Cough Out A Lung
While it is physically impossible to cough up a lung, you can cough out a lung. A 2012 article in the New England Medical Journal describes a woman coughing so hard that her lung was pushed between two of her ribs.
The 40-year-old patient had asthma and had been coughing markedly for two weeks. Apparently, the coughing was vigorous enough to herniate her right lung by rupturing an intercostal muscle between two of her lower ribs.
- rupturing your diaphragm
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Why Are People Coughing Up Blood
According to NBC News medical correspondent Dr. John Torres, a small study out of China found that “1% of COVID-19 patients complained of coughing up blood.”
“With pneumonias, coughing up blood can be a symptom, regardless of what caused the pneumonia, so it makes sense it could happen with COVID-19 as well,” Torres told TODAY, via email.
According to Dr. Albert Rizzo, the chief medical officer of the American Lung Association, there are many reasons for why someone might be coughing up blood.
“What happens is, airway inflammation sometimes leads to a very fragile lining of the airways, and those small blood vessels, or capillaries, might be affected, causing blood to come out,” he said, adding that coughing up blood can be caused by common illnesses like bronchitis or more severe diseases like lung cancer.
“The main issue is hemoptysis is a sign of airway inflammation,” Rizzo continued. “Certainly that can happen with COVID-19, and it speaks potentially to the severity of the inflammation when blood is being spit up along with mucus.”
Rizzo also said that the amount of blood one is coughing up can indicate how severe the situation is.
Rizzo warned that coughing up clots frequently is something that is very concerning, but less severe symptoms might not need immediate treatment.
Spot The Difference In Your Health
It can be difficult to keep track of symptoms so we have created a symptoms tracker where you can keep a note of:
- When you first spotted your chest infection
- How often you are coughing
- How long the infection is lasting
- If or when the chest infection returns
- Any pain, or other potential symptoms.
You can then take this along to your doctors appointment to give them the fuller picture of your symptoms.
Under the guidelines of the National Institute of Health and Care Excellence , your GP should offer you an urgent chest x-ray if you are:
- two or more symptoms including breathlessness, or
- one symptom and have ever smoked.
Symptoms for urgent chest x-ray include:
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How University Of Washington Coronavirus Unit Is Keeping Patients And Staff Safe
“Try to call ahead and notify someone that youre coming in because you may not have COVID-19 but right now people with those symptoms are being assumed to have COVID-19 and the proper precautions need to be taken,” Rizzo said. “The key thing in all this is communication what is the symptom, what are the other symptoms, let the health care provider make the decision about sitting at home or seeking further care.”
Causes Of Coughing Up Blood
There can be a lot of possible causes to coughing up blood, which may include:
- Chronic Obstructive Pulmonary Disease
Sometimes when you are coughing up blood, it may actually be coming from somewhere else, such as your stomach. The first step to treatment is to understand where the blood is actually coming from. The most common cause of coughing up blood is typically chronic bronchitis.
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What To Look For When You Cough Up Blood
Blood that comes from the lungs or respiratory tract will often appear bubbly. This is because it mixes with air and mucus in the lungs.
The color can range from rust-colored to bright red. The mucus may be entirely tainted with blood or only contain streaks of blood mixed with mucus.
Bleeding from the mouth is not the same as coughing up blood. If youre bleeding from your mouth, you may notice it when brushing your teeth or after eating.
A number of different issues can cause a person to cough up blood, ranging from irritation of the throat to lung cancer.
When To See A Doctor
In most of the cases, acute bronchitis is the cause of coughing up bloody mucus and it usually gets better without any treatment. The person should pay attention till the condition improves. However, it can also be a symptom of some serious medical condition and the doctor should be consulted immediately if any of the following symptoms are seen:
1. You have bloody mucus for more than a week, the intensity or severity of it increases or it occurs intermittently.
2. You see blood in the urine or stools as well.
3. You have chest pain and/or fever of 101 °F or higher.
4. There is unexplained weight loss or loss of appetite.
5. You experience shortness of breath even with regular activity.
6. You have soaking sweats at night.
Treatment for such conditions is usually done at the hospital till the causative factor is determined and there is no immediate threat of serious bleeding.
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What Is Coughing Up Blood
Coughing up blood involves coughing or spitting up blood or bloody mucus from your lower respiratory tract . Also called hemoptysis , coughing up blood is common and can have many causes. Most causes arent serious. However, you may need to visit an ER immediately if youre coughing up large amounts of blood.
Blood that you cough up often looks bubbly or frothy and is mixed with mucus or spit. It can appear pink, red or rust-colored and is usually in small amounts.
What is the difference between coughing up blood and vomiting blood?
Coughing up blood isnt the same as vomiting blood . Blood thats coughed up usually looks like blood-stained spit mixed with mucus. The blood comes from your throat or mouth. Vomiting blood involves spewing large quantities of blood. It usually involves internal bleeding in your upper gastrointestinal tract.
See a healthcare provider immediately if youre vomiting blood.
Is coughing up blood serious?
It can be. It all depends on whats causing your blood loss and the extent of your blood loss. Most causes arent serious and are treatable. Still, coughing up blood can be a sign of serious conditions, like a severe infection or lung cancer. Losing too much blood at once can be life-threatening and require emergency medical attention.
Only a healthcare provider can determine how serious your condition is. If youre coughing up large quantities of blood, or if your condition doesnt improve, see a provider.
What To Do If You Cough Up Blood
Your GP will check if you might have a serious medical condition that needs to be investigated and treated.
your nearest accident and emergency department immediately if you’re coughing up a lot of blood or are struggling to breathe.
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Getting A Diagnosis For Coughing Up Blood
If youre coughing up a lot of blood, call 999. You should also seek immediate medical attention if youre vomiting blood as this can be a sign of a serious problem with your digestive system.
If youre coughing up smaller amounts of blood, see your GP. Your GP will ask you how often you cough up blood, how much blood there is and any other symptoms. Theyll take a sample of your sputum and examine your chest and lungs.
Your GP will try to determine where the blood is coming from whether it is:
- Coming from your airways below the level of your voice box
- Coming from your lungs
- Haematemesis vomiting blood which causes coughing
- Pseudohaemoptysis blood comes from your mouth or nose and slides to the back of your throat causing you to cough eg during a nosebleed or if you have an inflamed throat
It can be difficult to determine whether coughed up blood is caused by haematemesis or pseudohaemoptysis. If the cause is not clear, your GP may refer you for further investigations, including:
In some cases, your GP may refer you to a consultant for further assessment, diagnosis and treatment.
How To Diagnose The Cause Of Coughing Up Blood
There are many tests that can be given when someone is coughing up blood. The main goal of the test is to determine the rate of bleeding and what are the risks to breathing. The first step of diagnosis will be to talk with your physician about your health history and what you are experiencing. A physical examination is usually completed as well. Your physician may then recommend a chest x-ray to see if there are any changes to lungs. The chest x-ray may show a mass, fluid, congestion, or may come back as completely normal. A computerized tomography scan may be requested if the x-ray does not show everything. A CT scan will give the physician a better view of the lungs. A bronchoscopy will help the physician to see directly into the airways and lungs, which may help identify the root of the problem. A complete blood count may also be requested to see the number of white and red blood cells that are in the blood. A urinalysis can show any abnormalities that are in the urine. A blood chemistry profile will measure electrolytes and kidney function. A coagulation test will show the bloods ability to clot, which may contribute to bleeding and coughing up blood.
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Inflammation And Abnormal Tissue Deposits
There are a number of conditions that can cause inflammation or produce abnormal tissue deposits in various parts of the body. Sometimes these conditions affect lung tissue or airways. Inflamed or abnormal tissue in the airways or lungs may bleed from time to time and cause haemoptysis. Conditions that can cause this include Goodpasture’s syndrome, pulmonary haemosiderosis, granulomatosis with polyangiitis, lupus pneumonitis, pulmonary endometriosis, and broncholithiasis. Note: these conditions are very rare and you would normally have other symptoms in addition to the haemoptysis.
Less Common Causes Of Coughing Up Blood
Less commonly, coughing up blood may be the result of:
- bronchiectasis this is more likely if you’re also wheezy or short of breath
- pulmonary embolism this usually causes sudden shortness of breath and chest pain
- pulmonary oedema your sputum will be pink and frothy, and this usually occurs in people with pre-existing heart problems
- lung cancer this is more likely if you’re over 40 and smoke
- cancer of the throat or windpipe
- taking anticoagulants medications that help stop your blood clotting, such as warfarin or other oral anticoagulants
Sometimes, in 15 to 20 per cent of cases, no cause can be found and it never happens again.
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It Definitely Warrants A Call To Your Healthcare Provider But It May Not Be Indicative Of Serious Disease
With decades of experience as a health, wellness, and fitness journalist, Leah Groth has one mission: To help you become the healthiest version of yourself. A Los Angeles native currently based in Philadelphia, her bylines appear in a number of magazines and websites, including Shape, Glamour, Forbes Health, Reader’s Digest, Everyday Health, Byrdie, CBS News, and Verywell. When she isn’t writing, she can be found exploring the east coast with her husband and two children. But most of the time, she is writing.
Jenny Sweigard, MD, is an internal medicine physician practicing general and critical care medicine at Novant Health Huntersville Medical Center and other hospitals in the North Carolina area.
Many know the key symptoms of COVID-19 by heart as well as some of the more serious or unexpected symptoms . However, according to research, a small percentage of COVID-19 cases have also reported the symptom of coughing up blood, and research has found evidence of reports of people coughing up blood with COVID-19.
Here’s what to know about the rare occurrenceand why healthcare providers say it may not always be indicative of serious disease .
Treating Blood In Mucus
Treatments for stopping blood in mucus will vary depending on the underlying cause.
Possible treatments include:
- Antibiotics: Antibiotics treat bacterial infections. Your doctor may prescribe antibiotics if you have pneumonia or tuberculosis.
- Blood product transfusion: When coughing up blood is due to thin blood or coagulants, or if there are clotting problems, your doctor may suggest a blood product transfusion.
- Chemotherapy or radiotherapy: These treatments may be used to treat lung cancer.
- Embolization: An embolization may be recommended if a major blood vessel is causing blood in the sputum. This process involves inserting a catheter into the vessel where bleeding is, and a metal coil, chemical, or fragment of gelatin sponge is used to seal it off.
- Steroids: Steroids can help with inflammatory conditions that are causing bleeding.
- Surgery: In rare cases, surgery may be carried out to remove a damaged or cancerous portion of the lung. This is usually only when bleeding is severe and/or persistent.
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About Coughing Up Blood
In up to one in five cases investigated, no cause is found for coughing up blood.
If you are coughing up blood, you may cough up:
- small amounts of bright red blood
- frothy blood-streaked sputum sputum is saliva and phlegm
The blood is usually from your lungs. Its often the result of coughing for long periods or a chest infection.
Mostly, if you cough up blood, the bleeding will stop on its own. In about five per cent of people the bleeding will be severe.
This bleeding can be life threatening – call 999 if this is happening.
If the blood is dark and contains bits of food or what looks like coffee grounds, it may be coming from your digestive system.
This may also be a serious problem. You should go to hospital straight away if you vomit up blood.