Coughing Up Blood

Overview

What is coughing up blood?

Coughing up blood (also called hemoptysis) refers to coughing or spitting up of blood or bloody mucus from your respiratory tract (lungs and throat). It's a common condition that can have many causes. Some of these conditions can be very serious.

Coughing up blood isn't the same as vomiting blood. Blood that's coughed up often looks bubbly and is mixed with mucus. It can be red or rust colored and is usually in small amounts. Vomiting blood refers to large quantities of blood being expelled from your mouth.

Possible Causes

What causes coughing up blood?

Causes of coughing up blood range from mild to serious. Bronchitis is the most common, and least serious, cause of coughing up blood.

Other causes may include:

  • Blood clot in the lung
  • Pulmonary aspiration (breathing blood into the lungs).
  • Lung cancer.
  • Excessive, violent coughing that irritates your throat.
  • Pneumonia.
  • Using blood thinners.
  • Tuberculosis.
  • Pulmonary embolism (blockage of an artery in your lungs).
  • Complications from lupus.
  • Congestive heart failure.
  • Irritation from a bronchoscopy biopsy.
  • Bronchiectasis (a condition that causes of enlargement of the arteries in your lungs).
  • Cystic fibrosis.
  • Vasculitis (inflammation of the blood vessels in your lung).
  • Injury to the arteries of your lungs.

Care and Treatment

How is the cause of coughing up blood diagnosed?

Since coughing up blood can range from mild to serious, it's important to diagnose the underlying cause of your symptoms so that you can be properly treated.

Your healthcare provider will begin an exam by asking how much blood you have been coughing up, for how long and how much is mixed with mucus.

The following tests may be done:

  • A computed tomography (CT) chest scan.
  • Chest X-ray to look for tumors or fluid in the lungs.
  • Lung scan.
  • Lung biopsy.
  • Bronchoscopy (a flexible tube inserted through the nose or mouth) to check if the airways are clear.
  • Blood count.
  • A sputum culture of your lung excretions to look for infection.
  • Blood clotting test.
  • Pulmonary arteriography to see how blood flows through your lungs.
  • Urinalysis.

How is coughing up blood treated?

Treatment for coughing up blood varies. Mild and temporary coughing up of blood can be treated by cough suppressants. However, if your coughing up of blood continues or worsens you should seek medical care.

Once the cause of coughing up blood is determined, your physician will talk with you about the best treatment plan that will address both your symptoms and the underlying condition. First, they may seek to stop the bleeding by embolizing (blocking) a bleeding artery or through a bronchoscopy.

Surgery and cancer treatment may be required if it is discovered your condition is caused by a tumor. Antibiotics may be prescribed for pneumonia or tuberculosis. Steroids may be used to treat inflammation causing the bleeding.

When to Call the Doctor

What should I do if I am coughing up blood?

Coughing up blood can be the sign of a serious medical condition.

If you're coughing up small amounts of blood for longer than a week, talk to your healthcare provider. They'll determine the cause of your hemoptysis.

Seek immediate attention if you are coughing up more than a few teaspoons of blood or your cough is accompanied by the following:

  • Chest pain.
  • Blood in your urine or stools.
  • Dizziness or light-headedness.
  • Shortness of breath.
  • Fever.
  • Rapid or severe weight loss.

Last reviewed by a Cleveland Clinic medical professional on 01/09/2018.

References

  • Merck Manual. Coughing Up Blood. (http://www.merckmanuals.com/home/lung-and-airway-disorders/symptoms-of-lung-disorders/coughing-up-blood) Accessed 2/13/2018
  • Prutsky G, Domecq JP, Salazar CA, Accinelli R. Antifibrinolytic therapy to reduce haemoptysis from any cause. Cochrane Database Syst Rev. 2016;11:CD008711.
  • Brown CA III. Hemoptysis. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 31.

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