Coughing-up Blood

Chest | Pulmonology | Coughing-up Blood (Symptom)


Coughing up blood is a symptom, medically known as haemoptysis, caused by rupture of a blood vessel in the airways, lungs, nose, or throat. It refers to expectoration of blood of blood-stained sputum from the bronchi, larynx, trachea, or lungs. The coughed-up blood may appear as bright-red or rusty-brown streaks, clots in the sputum, a pinkish froth, or, more rarely, blood alone.


The most common are infections, such as pneumonia or bronchitis; and congestion in and rupture of blood vessels in the lungs due to heart failure, mitral stenosis, or pulmonary embolism.

A cancerous tumour can also produce haemoptysis by eroding the wall of a blood vessel. In children, hemoptysis is commonly caused by the presence of a foreign body in the respiratory tract. The condition can also result from over-anticoagulation from treatment by drugs such as warfarin. Extensive non-respiratory injury can also cause one to cough up blood. Cardiac causes like congestive heart failure and mitral stenosis should be ruled out. Hemoptysis can also come from bleeding outside the lungs and airways. Severe nosebleeds or vomiting of blood from the stomach can result in blood draining into the windpipe (trachea). The blood is then coughed up, appearing as hemoptysis.

Diagnosis and Treatment

Tests for coughing up blood include: history and physical examination; chest X-ray; computed tomography (CT scan); bronchoscopy; complete blood count (CBC); urinalysis; blood chemistry profile; coagulation tests; arterial blood gas; pulse oximetry. Treatment depends largely upon the underlying cause.