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Coughing up blood

Hemoptysis; Spitting up blood; Bloody sputum

Coughing up blood is the spitting up of blood or bloody mucus from the lungs and throat (respiratory tract).

Hemoptysis is the medical term for coughing up blood from the respiratory tract.

Considerations

Coughing up blood is not the same as bleeding from the mouth, throat, or gastrointestinal tract.

Blood that comes up with a cough often looks bubbly because it is mixed with air and mucus. It is most often bright red, although it may be rust-colored. Sometimes the mucus contains only streaks of blood.

The outlook depends on what is causing the problem. Most people do well with treatment to treat the symptoms and the underlying disease. People with severe hemoptysis may die.

Causes

A number of conditions, diseases, and medical tests may make you cough up blood. These include:

  • Blood clot in the lung
  • Breathing food or other material into the lungs (pulmonary aspiration)
  • Bronchoscopy with biopsy
  • Bronchiectasis
  • Bronchitis
  • Cancer
  • Cystic fibrosis
  • Inflammation of the blood vessels in the lung (vasculitis)
  • Injury to the arteries of the lungs
  • Irritation of the throat from violent coughing (small amounts of blood)
  • Pneumonia or other lung infections
  • Pulmonary edema
  • Systemic lupus erythematosus
  • Tuberculosis
  • Very thin blood (from blood thinning medications, most often at higher than recommended levels)

Home Care

Medicines that stop coughing (cough suppressants) may help if the problem comes from heavy coughing. These medicines may lead to airway blockages, so check with your health care provider before using them.

Keep track of how long you cough up blood, and how much blood is mixed with the mucus. Call your provider any time you cough up blood, even if you do not have any other symptoms.

When to Contact a Medical Professional

Get medical help right away if you cough up blood and have:

  • A cough that produces more than a few teaspoons of blood
  • Blood in your urine or stools
  • Chest pain
  • Dizziness
  • Fever
  • Lightheadedness
  • Severe shortness of breath

What to Expect at Your Office Visit

In an emergency, your provider will give you treatments to control your condition. The provider will then ask you questions about your cough, such as:

  • How much blood are you coughing up? Are you coughing up large amounts of blood at a time?
  • Do you have blood-streaked mucus (phlegm)?
  • How many times have you coughed up blood and how often does it happen?
  • How long has the problem been going on? Is it worse at some times such as at night?
  • What other symptoms do you have?

The provider will do a complete physical exam and check your chest and lungs. Tests that may be done include:

References

Brown CA, Raja AS. Hemoptysis. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 24.

Swartz MH. The chest. In: Swartz MH, ed. Textbook of Physical Diagnosis. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 10. 

         

        Review Date: 4/24/2017

        Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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