Coughing up blood

Alternative Names Hemoptysis; Spitting up blood; Bloody sputum

Definition

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 usually bright red, although it may be rust-colored. Sometimes the mucus may only contain streaks of blood.

Causes

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

• Blood clot in the lung
  Bronchiectasis
  Bronchitis
  Cancer
  Cystic fibrosis
  Goodpasture's syndrome
  Inflammation of the blood vessels in the lung (vasculitis)
  Inhaling blood into the lungs (pulmonary aspiration)
  Irritation of the throat from violent coughing
  Nosebleed that drips blood down into the lungs
  Laryngitis
  Pneumonia
  Pulmonary edema
  Systemic lupus erythematosus
  Tuberculosis
  Diagnostic tests that can make you cough up blood include:
  Bronchoscopy
  Laryngoscopy
  Lung biopsy
  Mediastinoscopy
  Spirometry
  Tonsillectomy
  Upper airway biopsy

Home Care

Cough suppressants may help if this condition is due to throat irritation from violent coughing. However, cough suppressants may lead to airways obstruction in some cases. Always check with your doctor before using them.

It is very important to note how long you cough up blood, and how much blood is mixed with the mucus.

• 
  Also look out for these signs of severe blood loss:
  Dizziness
  Light-headedness
  Thirst
  Other symptoms:
  Blood in the urine
  Chest pain
  Fever
  Shortness of breath

When to Contact a Medical Professional

If you have any unexplained coughing up of blood, call an ambulance or go to the nearest emergency department. This is very important if your cough produces large volumes of blood (more than a few teaspoons), or if you also have:

• 
  Dizziness
  Light-headedness
  Severe shortness of breath

What to Expect at Your Office Visit

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

• 
  Type
  Are you coughing up large amounts of blood (massive hemoptysis)?
  Can you see blood when you cough up something?
  How many times have you coughed up blood?
  Is there blood-streaked mucus (phlegm)?
  Time pattern
  Did it begin suddenly?
  Has it increased recently?
  How many weeks has the cough lasted?
  Is the cough worse at night?
  What other symptoms do you have?

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

• 
  Bronchoscopy
  Chest CT scan
  Chest x-ray
  Coagulation studies, such as PT or PTT
  Complete blood count
  Lung biopsy
  Lung scan
  Pulmonary arteriography
  Sputum culture and smear

References

Rakel RE. Textbook of Family Practice. 6th ed. Philadelphia, Pa: WB Saunders; 2005:402-413.
Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: WB Saunders; 2000:497.
Update Date: 11/12/2007
Updated by: Andrew Schriber, M.D., F.C.C.P., Specialist in Pulmonary, Critical Care, and Sleep Medicine, Virtua Memorial Hospital, Mount Holly, New Jersey. Review provided by VeriMed Healthcare Network

Published in

http://www.nlm.nih.gov/medlineplus/ency/article/003073.htm