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- Coughing up blood is usually a cause for concern and should be addressed immediately.
- Serious conditions that may cause you to cough blood are lung cancer and congestive heart failure.
- Seek emergency care if you also have other symptoms like fever and chest pain.
Coughing up blood can be a terrifying experience, even if it's just a few drops.
While coughing up blood isn't always cause to go straight to the hospital, you should seek immediate attention if you're experiencing:
- Coughing up more than a few teaspoons of blood
- Chest pain
- Shortness of breath
- Blood in your urine or stool
- Rapid or severe weight loss
Coughing up blood can be caused by anything from drinking alcohol to experiencing severe heart failure. It can also be from a short-term condition, such as pneumonia, or a lifelong condition like cystic fibrosis.
Here are some of the most common causes of a bloody cough and an overview of what you should know.
1. Chronic bronchitis
What is it? Chronic bronchitis refers to long-term inflammation of the bronchi, your breathing tubes and is the most common cause of hemoptysis — the medical term for coughing up blood from your respiratory tract.
With chronic bronchitis, you might only cough up a red streak of blood one time. However, some people with chronic bronchitis experience several episodes of coughing blood that happen sporadically over a handful of years.
You are most at risk for chronic bronchitis if you are a cigarette smoker, but other risk factors include:
- Inhaling secondhand smoke
- Inhaling air pollution
- Exposure to chemical fumes
- Frequent contact with dust
- Having an Alpha-1 antitrypsin deficiency, an inherited condition where your body lacks the protein that protects your lungs from infections
- Being over age 40
Chronic bronchitis is one of the most common conditions contributing to chronic obstructive pulmonary disease (COPD).
Is it serious? Unlike acute bronchitis, which often comes from a standard cold and goes away in a week or two, chronic bronchitis is a serious condition that develops over time. While your symptoms might get better or worse, they never entirely disappear.
These long periods of inflammation can cause sticky mucus to build up in your airways, leading to long-term breathing difficulty.
Other common symptoms include:
- Smoker's cough
- Coughing up mucus
- Wheezing or crackling sounds when breathing
- Chest discomfort
- Trouble breathing
How to treat it: While chronic bronchitis does not have a cure, there are a handful of treatments to help you live more comfortably through controlling symptoms.
Your doctor can diagnose chronic bronchitis and recommend the best treatments to open your airways. These may include oral medications, inhaled steroids, and pulmonary rehab to help you live more comfortably with your breathing problems.
If you smoke, quitting is widely considered the most essential to alleviating symptoms.
What is it? Pneumonia is an often serious infection that can occur in one or both of your lungs. With pneumonia, the air sacs in your lungs fill with pus or other fluid, which can give you trouble breathing.
See your doctor immediately if you or a loved one may have pneumonia and is:
- Over age 65
- Below age 2
- Taking medication that suppresses the immune system (like prednisone or Humira)
- Affected by other health conditions like asthma, cystic fibrosis, or a heart, kidney, or a liver condition
Do I have it? Symptoms of pneumonia can develop in 24 hours, or they may come on slowly over several days.
You may cough up blood-stained phlegm that is thick and dry in consistency. This phlegm may be yellow, green, or brown in color.
Common symptoms also include:
- Trouble breathing (rapid or shallow, breathlessness while resting)
- Rapid heartbeat
- Loss of appetite
- Worsening chest pain when breathing or coughing
How to treat it: Some cases of pneumonia can go away on their own if you get plenty of rest and fluids. However, this depends on the cause and severity of your symptoms.
There are over 30 different infections that can cause pneumonia including bacterial, viral, and fungal. Therefore, your treatment will depend on the type of infection.
For example, treatment may require oral antibiotics for a bacterial infection, antivirals for a viral infection, or antifungals for a fungal infection, so it's best to reach out to your doctor if you think you may have pneumonia.
Severe cases may also require a hospital stay for intravenous (IV) antibiotics or oxygen therapy.
3. Lung cancer
People who smoke have the highest risk of developing lung cancer. Smoking tobacco, specifically, causes 90% of cases in men and 80% of cases in women.
Other common causes of lung cancer include inhaling secondhand smoke, a family history of lung cancer, and exposure to certain chemicals like radon or asbestos.
Is it serious? Lung cancer is the leading cause of cancer deaths worldwide. Moreover, relative survival rates for lung cancer are low, making this a serious condition.
The five-year relative survival rate for non-small cell lung cancer is 26%, while the five-year relative survival rate for small cell lung cancer is 7%.
Do I have it? Coughing up blood is one of the most common symptoms of lung cancer. Lung cancer is more likely than other conditions to produce large amounts of blood in your cough (massive hemoptysis), sometimes leading to hospitalization.
Other symptoms include:
- A cough that doesn't go away, or worsens
- Worsening chest pain when coughing, laughing, or breathing deeply
- Hoarse voice
- Shortness of breath
- Feeling tired or weak
- New wheezing
- Loss of appetite or unexplained weight loss
- Chronic or recurring cases of pneumonia or bronchitis
How to treat it: If you think you might have lung cancer, you should see your doctor as soon as possible. When lung cancer is found earlier, it is more likely to be treated successfully.
Common treatments for lung cancer include:
- Lung surgery
- Radiation therapy
- Stereotactic body radiotherapy
- Targeted drug therapy
You and your provider will choose a treatment plan based on your overall health, the type and stage of your cancer, and your preferences.
4. Congestive heart failure
What is it? Congestive heart failure is a chronic condition where your heart doesn't pump blood as efficiently as it typically does. It's sometimes just referred to as "heart failure."
As a result, your heart can't keep up with your body's demands, and blood returns to the heart faster than it can be pumped out. This creates a pumping issue that prevents oxygen-rich blood from flowing to your other organs — including your lungs. As a result, your lungs fill with fluid.
Is it serious? Congestive heart failure is a serious condition. Over time, your heart can't keep up with its normal ability to pump blood to the rest of the body, which can be life-threatening.
Do I have it? You may experience a chronic cough with pink blood-tinged mucus if you have congestive heart failure. Symptoms like coughing blood happen as your heart weakens and loses its usual ability to pump blood successfully through your body.
Other common symptoms include:
- Shortness of breath when active or lying down
- Fatigue or weakness
- Swelling of the legs, ankles, and feet
- Rapid or irregular heartbeat
- Abdominal swelling
- Reduced ability to exercise
- Nausea or loss of appetite
- Trouble concentrating
- Chest pain
How to treat it: If you're experiencing heart failure, seeing a doctor as soon as possible for proper treatment can help you reduce symptoms and live longer.
Call 911 if you're experiencing any of the following:
- Chest pain
- Extreme weakness
- Rapid or irregular heartbeat with shortness of breath, chest pain, or fainting
- Sudden, severe shortness of breath while coughing up white or pink, foamy mucus
Treatment typically includes medication and lifestyle changes like exercising, reducing sodium and caffeine intake, losing weight, and managing stress. Your doctor may also recommend surgery and additional therapies in severe cases.
5. Cystic fibrosis
What is it? Cystic fibrosis (CF) is an inherited disease that affects around 35,000 people in the United States. It causes persistent lung infections that eventually limit your ability to breathe.
Is it serious? With CF, your lung function can gradually worsen until it becomes life-threatening.
CF creates dangerously thick and sticky mucus that blocks airways, damages your lungs, and increases your risk of infection. CF can also prevent proteins your body needs for digestion from reaching your intestines, which decreases your ability to absorb essential nutrients.
Do I have it? The combination of airway damage and frequent infections that may occur with CF can cause you to cough up a small amount of blood.
Other symptoms of CF may include:
- Very salty-tasting skin
- Persistent coughing, sometimes with phlegm
- Frequent lung infections like pneumonia or bronchitis
- Chronic sinus infections
- Shortness of breath
- Poor growth and weight gain
- Frequent greasy, bulky stools
- Rectal prolapse
- Chronic or severe constipation
- Clubbing or enlargement of the fingertips or toes
While most people with CF are diagnosed in early childhood, some don't receive a proper diagnosis until adulthood.
How to treat it: Even coughing up a small amount of blood can be life-threatening and a sign to seek immediate medical care if you have CF.
Cystic fibrosis requires consistent care from your provider, at least once every three months.
If you or your child has symptoms of CF, or if someone in your family has CF, discuss testing with your doctor as soon as possible.
While there is no cure for CF, treatment can ease symptoms, reduce complications, and improve quality of life.
Treatment may include stool softeners, antibiotics, bronchodilators, and more based on your symptoms. CF symptoms and their severity can differ widely, so treatment plans are tailored to your unique needs.
"If you're coughing up bright red blood, the blood is likely new or fresh. This type of blood is usually from the throat, lungs, or upper gastrointestinal tract and can have any number of causes," says Jenna Liphart Rhoads, a registered nurse at NurseTogether. These causes can range from moderate to severe.
Here are a few other conditions to consider, according to experts.
Endometriosis is another, less frequent, culprit for coughing up blood.
"If endometrial tissue develops around the lungs, it can get inflamed and bleed during the woman's normal cycle. The only way out would be through coughing out sputum, a mixture of saliva and mucus that may include blood," says Nancy Mitchell, a registered nurse at Assisted Living Center.
Tuberculosis is a serious disease caused by bacteria. This condition usually attacks your lungs and is highly contagious through coughing and sneezing.
"A fever is enough reason to call coughing blood an emergency because high body temperatures can be a sign of tuberculosis, which is highly contagious," Mitchell says.
Mitchell adds that you could also be protecting others by protecting yourself from severe causes of coughing up blood. "Your diligence in reporting symptoms could prevent a massive outbreak if your health provider sees a need to perform contact tracing," Mitchell says.
About 50% of people with lupus will experience lung issues during the course of their disease. Acute lupus pneumonitis is a severe lung condition that affects up to 10% of lupus patients and is characterized by chest pain, shortness of breath, and a dry cough that may bring up blood.
It's important to speak with your doctor right away to reduce your risk of lung scarring.
Goodpasture syndrome is a rare autoimmune disease in which your body mistakenly attacks your lungs and kidneys, which may cause your lungs to bleed. Other symptoms include respiratory issues, blood in your urine, anemia, chest pain, nose bleeds, and kidney failure.
"In addition to coughing up blood, a patient with Goodpasture syndrome may also present with kidney failure," says Dr. Jyoti Matta, a pulmonologist, and Medical Director at the Center for Sleep Disorders at Jersey City Medical Center.
Goodpasture syndrome can be fatal if left untreated, so it's important to bring up any symptoms to your doctor if you're concerned.
"However, this is a very rare condition and not the first that comes to mind when a patient is coughing up blood," Matta says. There are between 300 and 3,000 cases of Goodpasture syndrome in the United States.
Antineutrophilic cytoplasmic antibody (ANCA) associated vasculitides are a group of uncommon autoimmune conditions that cause inflamed blood vessels and affect approximately 1 in 50,000 people.
This group includes three main diseases:
- Granulomatosis with polyangiitis
- Eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome)
- Microscopic polyangiitis (MPA)
Previously called Wegener's granulomatosis, granulomatosis with polyaniitis is a rare but serious condition that causes inflammation of the blood vessels in your sinuses, throat, lungs, nose, and kidneys.
"Wegener's may cause a patient to cough up blood intermittently. People in their 30s on can be diagnosed with this rare condition," Matta says. Besides coughing up bloody phlegm, you might also experience joint pain, pus-like drainage from your nose, sinus infections, fatigue, and coughing with bloody phlegm.
"Low-dose steroids may help keep these conditions under control when there are flare-ups. Typically, when a person coughs up blood, they usually have a bout of bronchitis, pulmonary edema, infection, and inflammation, and not ANCA-associated vasculitis," Matta says.
However, since these disorders can be fatal without proper care, as the continuous inflammation in your blood vessels and organs can result in kidney or lung failure, it's worth seeing your doctor if you're repeatedly coughing up blood.
Many things could contribute to coughing up blood, so you should see your doctor to find the correct diagnosis and treatment.
"Coughing up blood almost always means there's an underlying condition – often a mix of infection and severe inflammation," Mitchell says.
"You should always seek medical attention when coughing up blood and not attempt to treat it at home," Rhoads agrees.