Tasting blood when you cough can be alarming. This experience, medically termed a metallic taste or, if visible, hemoptysis, can arise from various sources within the respiratory system, mouth, or nose. While often stemming from minor issues, understanding the potential underlying causes is important. Knowing when this symptom warrants medical attention is also crucial.
Common Explanations for the Taste
Many instances of tasting blood while coughing are due to common, benign factors. Dry air or dehydration can irritate the delicate lining of your airways, leading to tiny tears in small blood vessels. This allows minute amounts of blood to mix with mucus and saliva, creating a metallic taste. Similarly, a strong or persistent cough, often associated with bronchitis or a cold, can cause minor irritation and bleeding in the respiratory passages. The force of coughing can rupture small capillaries, leading to a metallic taste.
Minor bleeding from the mouth or gums can also contribute to this sensation. Conditions like gingivitis, characterized by inflamed and bleeding gums, can release small amounts of blood that mix with saliva. Nosebleeds, especially those originating deeper in the nasal passages, can cause blood to drain down the back of the throat. This trickling blood can then be tasted or coughed up, giving the impression it’s from the lungs.
Acid reflux (GERD) can sometimes mimic respiratory symptoms and cause a metallic taste. Stomach acid traveling up the esophagus can irritate the throat and airways, sometimes leading to minor bleeding or an altered taste sensation. Even intense physical exertion, such as vigorous running, can cause a temporary metallic taste. This occurs when increased pressure in the lungs during strenuous activity ruptures tiny capillaries in the airways, releasing small amounts of red blood cells. These minor ruptures are generally harmless and resolve quickly.
When the Taste Signals a More Significant Issue
A persistent or concerning blood taste when coughing can sometimes indicate a more significant underlying health condition. Respiratory infections like pneumonia or severe bronchitis can cause inflammation and damage to lung tissues, leading to visible blood in phlegm or a metallic taste. These infections may cause small blood vessels to leak into the mucus.
Conditions like asthma, especially during exacerbations, can contribute to this symptom. Severe coughing fits can irritate the airways enough to cause minor bleeding. More serious lung conditions, such as bronchiectasis, involve damaged airways prone to chronic infections and inflammation, leading to increased mucus and potential bleeding. Tuberculosis, a bacterial infection primarily affecting the lungs, is also known to cause coughing up blood due to lung tissue damage.
Conditions affecting the cardiovascular system can also manifest with this symptom. Pulmonary embolism, a blood clot in the lungs, can lead to tissue damage and bleeding. Heart conditions, like congestive heart failure, can cause fluid to back up into the lungs, increasing pressure in blood vessels and potentially leading to a bloody cough. While rare, cancers affecting the lungs or airways can also result in bleeding as tumors grow and erode into surrounding tissues and blood vessels.
When to Seek Medical Attention
Seek medical attention if the taste of blood when coughing is persistent or accompanied by other concerning symptoms. If the blood taste lasts for more than a few days, or if you begin to see visible blood in your phlegm or cough, a medical evaluation is warranted.
Additional symptoms signaling a need for prompt medical assessment include shortness of breath, chest pain, or dizziness. Unexplained weight loss, night sweats, or a fever that does not resolve are also important indicators requiring investigation. Any significant change in your cough pattern, particularly if it becomes more frequent, severe, or productive of bloody mucus, should be discussed with a doctor. Individuals who smoke or have a history of lung disease should be particularly vigilant and seek medical advice for new or worsening symptoms.
How Healthcare Professionals Investigate
When you consult a healthcare professional about tasting blood when coughing, they will typically begin with a detailed medical history and a physical examination. This initial step helps them gather clues about potential causes and the severity of the symptom. They will ask about the duration, frequency, and amount of blood, as well as any other accompanying symptoms.
Following the history and physical, several diagnostic tests may be considered. A chest X-ray is often an initial imaging study to check for lung abnormalities like infections, fluid, or masses. Depending on X-ray findings, a computed tomography (CT) scan of the chest may provide more detailed images. Blood tests, including a complete blood count (CBC), can assess for infection or anemia, and coagulation tests can check for bleeding disorders. Sputum analysis, where a sample of coughed-up mucus is examined, can help identify infectious causes like bacteria or tuberculosis. In some cases, a bronchoscopy, which involves inserting a thin, flexible tube with a camera, might be necessary to visualize the source of bleeding or collect samples.