A variety of diseases and infections of the respiratory system can cause an individual to cough up blood. Blood in the lungs and airway may be symptomatic of a relatively minor infection or underlie a more serious chronic disease. The amount of blood ranges from a bit contained in phlegm or sputum to, in cases of massive hemoptysis, more than two cups in 24 hours. The appearance of the blood also varies, from small streaks to bright red clots.
Coughing up blood is most often a symptom of bronchitis. This respiratory infection causes a severe, persistent cough due to irritation and swelling of the bronchi, the airways branching from the windpipe to the lungs. A virus, including the common cold virus, usually triggers this condition. Inflammation of the airway and frequent coughing fits may produce mucus streaked with blood. Bronchitis is not often considered a serious medical concern and, unless the condition turns chronic, treatment is confined to medication to prevent irritation and coughing.
A more severe, chronic respiratory illness is bronchiectasis. Coughing up blood is often the only symptom of this permanent condition of the airway. Recurring respiratory infections damage the walls of the respiratory tract and increase the susceptibility of broken blood vessels in the tissue. The damage caused by bronchiectasis is irreversible. Treatment consists of measures to prevent further damage and manage inflammation. Recurring respiratory infections require antibiotics, and doctors may use breathing therapies to alleviate symptoms.
Coughing up blood can be a symptom of a pulmonary embolism or a blood clot in the blood vessels of the lungs. An embolism occurs when a blood clot in a deep vein elsewhere in the body travels through the bloodstream and into the lungs, blocking the flow of blood. A person experiencing a blood clot in the lungs might cough up blood that is bright red, clotted, or phlegm streaked with blood. Anticoagulants that dissolve blood clots can treat pulmonary embolisms.
Pneumonia is an infection of the lungs due to a bacterium or virus. It often occurs in the end stages of chronic disease, when immunity is inhibited. This, combined with a respiratory system incapable of adequate inhalation and exhalation, leaves the lungs susceptible to infection. The development of leaking blood vessels may occur as a result of the infection, leading to a person coughing up phlegm or sputum streaked with blood. Antibiotic or antiviral medication treats pneumonia. The doctor may also use supportive breathing therapies.
Tuberculosis is a highly contagious bacterial infection transmitted through sneezing and coughing. When tuberculosis infects the lungs, lesions form in the organ tissue. These lesions damage blood vessels, resulting in coughing up clotted red blood. A doctor will prescribe antibiotics to treat tuberculosis. If coughing continues to bring up blood, an individual may require surgery to remove a portion of his or her infected lung.
When blood pooled in the lungs is coughed up in phlegm, it may signify primary or metastatic lung cancer. Primary lung cancer arises in the bronchi and alveoli, and metastatic lung cancer occurs when cancer spreads to the organ from other parts of the body. Smoking accounts for the majority of cases of lung cancer. The condition is treated with chemotherapy, radiation therapy, or surgery.
Heart failure occurs when the heart is no longer capable of adequately pumping blood throughout the body. Disease, heart attack, and damaged heart valves can all lead to this complication. As a result, blood may collect in the lungs and cause an individual to cough up pink, frothy fluid. Long-term management of heart failure incorporates medication, surgical procedures, device implantation, and transplants.
When a person with cystic fibrosis coughs up blood, this often indicates an infection in the lungs. Cystic fibrosis is a chronic condition that causes mucus in the lungs to be abnormally thick and sticky. This results in airway constriction and increased respiratory infections. Lung infections may irritate blood vessels, causing expectoration of bloody phlegm. The amount of blood is usually minimal, and when excessive, an individual may require hospitalization and blood transfusions. Antibiotics and therapies to clear the airway treat lung infections in people with cystic fibrosis.
Vasculitis, broadly, is inflammation of the blood vessels. Pulmonary vasculitis comprises several diseases of the blood vessels in the lungs. Inflamed, damaged, or diseased blood vessels in the lungs can lead to ruptures. Coughing up blood is a common symptom of an underlying vascular disorder. Treating pulmonary vasculitis depends on the particular type of inflammation. Overactivity of the immune system is a common feature of vasculitis, so doctors often prescribe immunosuppressants.
A lung abscess is an infection caused by inhaling secretions produced naturally in the mouth. They are most common in those with gum disease and poor oral health and tend to happen when the individual is semi-conscious or unconscious. A lung abscess occurs as a cavity in the tissue of the lung, which then fills with pus. Irritation of the tissue results in bleeding, which is coughed up in foul-smelling or -tasting sputum. Doctors treat abscesses with antibiotics, and they may require draining.