Coughing up Blood (Haemoptysis)



Haemoptysis is the medical word for coughing up blood. This is usually due to a problem within the airways or lungs. The severity (amount of blood) can vary from a small amount of blood to substantial of blood.

If you cough up a lot of blood,this is an emergency. Especially if the bleeding does not stop and you are losing a lot of blood. You should call an ambulance urgently. However, this situation is uncommon.

Often the blood is mixed in with the sputum (spit). This is common. Sometimes there is a small amount of blood mixed with sputum each time you cough.No matter how small the amount of blood, you should see your doctor soon. Coughing up blood is a symptom which may indicate a serious disease.

Other symptoms may occur at the same time as coughing up blood. For example, cough, chest pain, breathlessness, fever, feeling unwell, wheeze or other lung symptoms. Sometimes there are no other symptoms at.

What are the causes of coughing up blood?

There are many possible causes. Below is a brief overview of the more common and important causes:


Tuberculosis of the lung used to be a very common cause of haemoptysis. Acute bronchitis and pneumonia being second commonest . But, infection anywhere in the airways may potentially can cause it. Typically, the blood is mixed up with sputum,accompanied with symptoms related to the infection such as fever , feeling of being unwell. Hemoptysis goes when the infection clears.


One of the earliest symptoms of lung cancer is often coughing up blood or bloodstained sputuM. Most lung cancers develop in people over the age of 50, most commonly in smokers. Rarely unusual types of lung cancer can affect younger non-smoking people.


Bronchiectasis is an abnormal widening of one or more airways. Extra mucus is made in the abnormal airways,. The main symptom is a cough which produces a lot of sputum. You may also cough up some blood from the abnormal inflamed airway. This is typically just small amounts of blood now and then. Inhaled objects and trauma.

A pulmonary embolism

A pulmonary embolism is a serious, potentially life-threatening condition. The main symptoms are usually chest pain and breathlessness, but haemoptysis may also occur.

Heart and blood vessel problems

Severe heart failure can cause a build-up of fluid in the lungs. The main symptom is usually breathlessness but the sputum may become frothy and bloodstained.

Inflammation and abnormal tissue deposits

These conditions are rare, and you would normally have other symptoms in addition to the haemoptysis..They areGoodpasture's syndrome, pulmonary haemosiderosis, Wegener's granulomatosis, lupus pneumonitis, pulmonary endometriosis, broncholithiasis.

No cause identified

Despite tests, no cause can be found in some people with haemoptysis. This is called idiopathic haemoptysis. So, in some people the cause of the bleeding remains a mystery. Perhaps in these cases it is just a small blood vessel that bursts and bleeds for a while - a bit like a nosebleed. However - never assume that there will be no cause found. Always see a doctor if you cough up blood and the cause is not known. The diagnosis of idiopathic haemoptysis can only be made once other more serious causes can be ruled out.

What should I do if I cough up blood?

If you cough up lots of blood then you should call an ambulance, as this is a medical emergency.

If you cough up one or more small amounts of blood and you do not know the cause then see a doctor promptly.

What assessment and tests may be done?

A doctor's assessment

Your doctor is likely to ask various questions about the nature of the bleeding, and ask if you have any other symptoms. He or she will also examine you. One of the first things a doctor will try to find out is ... "is this blood truly coming from the airways or lungs?". Sometimes it is difficult to be sure.

 True haemoptysis is the coughing of blood that comes somewhere from the lung or airways below the level of the larynx. But sometimes it can be difficult to say.

Haematemesis - that is, when the blood is vomited blood but the vomiting may cause you to cough as you vomit.
Pseudohaemoptysis - that is, when the blood comes from somewhere in your mouth or nose that tracks to the back of your throat, which then causes you to cough. For example, from a nosebleed.

Following a doctor's assessment, your doctor may refer you for one or more tests. The tests done can vary depending on the suspected cause (which is often based on your other symptoms). Tests that are commonly done following an unexplained haemoptysis include one or more of the following.

Chest X-ray
CT Scan

A bronchoscopy is a procedure where a doctor looks into your large airways (It is about as thick as a pencil. The bronchoscope is passed through the nose or mouth, down the back of the throat, into the windpipe (trachea), and down into the bronchi.

Blood tests
A range of blood tests can help to diagnose various conditions.

Other tests

Various more sophisticated tests and scans may be advised if the diagnosis or extent of the problem remains unclear despite the above tests.

What is the treatment for coughing up blood?

The treatment depends on the cause.

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