Coughing up blood

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

[ 1 ], [ 2 ]

What causes coughing up blood?

Bronchitis, in any form - acute or chronic. If coughing up blood is accompanied by a high temperature, most likely the inflammation of the mucous epithelial membrane of the bronchial tree is acute. Chronic 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 inclusions, often combined with pus.

Bronchiectasis or bronchiectatic disease is a purulent process in deformed bronchi, accompanied by persistent prolonged cough. The bronchial secretion contains small streaks of pus and blood. Endobronchitis can also be accompanied by subfebrile temperature, shortness of breath and general weakness

Cardiopathology – rheumatism of the valves, defects. Coughing up blood is caused by changes in blood circulation and congestive respiratory phenomena. Blood stagnation (hypertension) also forms in the lungs, which leads to shortness of breath and expectoration of sputum with blood inclusions.

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

Traumatic injuries of the trachea, bronchi. The injury may be associated with both a domestic cause (a blow) 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.

Gastrointestinal tract diseases localized in the digestive tract, its upper zones - ulcerative processes of the esophagus, erosive lesions of the duodenum, gastric ulcer. Coughing up blood is often confused with vomiting, typical for ulcerative lesions of the digestive system. Blood in the discharge is present in the form of clots of a dark, reddish hue.

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

Oncological pathology of the lungs. Coughing up blood is one of the most characteristic signs of lung cancer. Bloody thread-like inclusions in secretions (sputum), increased sweating, shortness of breath, gradual weight loss are threatening signs of the oncological process.

A purulent lung abscess is most often a consequence of protracted pneumonia. Coughing up blood, regular jumps in body temperature, increased sweating, painful sensations 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 itself with clinical signs at the first stage of development, can be suspected by a cough symptom with the discharge of sputum with bloody streaks.

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

When does coughing up blood require a doctor's attention?

• Cough accompanied by copious discharge of blood.
• Coughing up blood, combined with sudden weight loss.
• Persistent cough, paroxysmal and regular cough with bloody streaks.
• Shortness of breath when immobile, at rest.
• Severe pain in the chest area, accompanied by a cough.
• Excessive sputum secretion with bright red blood (a sign of pulmonary hemorrhage). Urgent medical attention is needed.

How is coughing up blood diagnosed?

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

• An X-ray examination of the chest, which examines the condition of the pulmonary system and heart. Any darkening on 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 cardiological examinations to confirm or exclude a valve defect.
• Bronchoscopic examination is intended to clarify the diagnosis of lung cancer, bronchiectasis. The lumen of the bronchial tree is examined to detect tumors or pathological expansions.
• Coughing up blood can signal a number of serious illnesses that can be diagnosed using CT scanning.
• Bacterial examination of secretions and sputum allows to identify the causative agent of the inflammatory process in the bronchopulmonary system. A similar method is used to determine mycobacteria - Koch's bacilli if 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 metabolism.
• A standard study is a complete blood count (CBC), which shows changes in the quantitative indicators of leukocytes and determines the erythrocyte sedimentation rate (ESR). CBC helps to clarify the form of the disease - chronic or acute.
• A study of blood coagulation activity - a coagulogram - is mandatory.
• If a heart defect is suspected, an ultrasound of the heart and a cardiographic examination are prescribed.
• In case of clinical manifestations of the ulcerative process of the gastrointestinal tract, FEGDS is prescribed - gastroscopy, which examines the upper zone of the digestive system.

How to treat coughing up blood?

The therapeutic strategy for treating cough symptoms accompanied by expectoration of 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, cough treatment is usually symptomatic. In cases of inflammatory processes, complex antibacterial therapy is prescribed; if the etiology of the disease is viral, 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 stomach ulcer, surgery is unavoidable. If coughing up blood is one of the symptoms of cystic fibrosis, it is controlled with lifelong intake of mucolytic drugs. Today, cystic fibrosis is considered an incurable disease, however, provided that a complex of drugs is regularly taken, which in addition to mucolytics includes enzymatic agents, antibiotics, hepatoprotectors, a special diet is followed and breathing exercises are constantly performed, patients live a fairly full and high-quality life.