Coughing up blood or hemoptysis refers to the spitting of blood or blood-stained mucus from the throat and lungs (the respiratory tract). Coughed up blood often looks bubbly and is mixed with mucus. It may be red or rust-colored in appearance. It is often small in amounts, unlike vomiting blood where a large amount of blood is expelled or vomited from the mouth.
Coughing up blood may be caused by certain benign conditions such as a throat infection or very severe conditions such as lung cancer. Due to the possibility of serious underlying conditions, coughing up blood should not be ignored.
Some of the causes of coughing up blood are as follows:
- Pulmonary embolism (blood clot in the lungs)
- Aspiration (accidental entry of food or other material into the lungs)
- Lung cancer
- Violent or excessive coughing
- Lung infections such as pneumonia
- Bronchoscopy with biopsy
- Bronchiectasis (a condition that causes enlargement of the arteries in the lungs)
- Bronchitis (inflammation of the inner lining of the bronchi present in the lungs)
- Cystic fibrosis
- Vasculitis (inflammation of the blood vessels in the lungs)
- Injury to the arteries of the lungs
- Pulmonary edema (a condition caused by excess fluid in the lungs)
- Congestive heart failure
- Autoimmune conditions such as lupus
- Certain medications
Is a little blood in phlegm normal?
You may get little streaks of blood in phlegm due to reasons such as excessive coughing. Blood in phlegm, however, may be due to serious conditions such as lung cancer, pulmonary embolism, and heart failure.
You must seek medical care for blood in cough/phlegm if:
- The coughing up of small amounts of blood lasts more than a week.
- You are coughing up more than a few teaspoons of blood.
- There is a presence of blood in the urine or stools.
- You have shortness of breath.
- You experience chest pain.
- You feel light-headed or dizzy.
- There is a presence of fever.
- You have rapid or excessive unintended weight loss.
How would I know why I am coughing up blood?
Coughing up blood may be caused by various conditions that may range from mild to serious. To know the exact cause of coughing up blood, you need to consult a doctor. Your doctor may ask details about coughing up blood such as since when you are having it, how much blood you cough up, and whether you have other complaints such as breathlessness, fever, and chest pain. They may also ask about your history of taking any medications or smoking.
To diagnose the cause of coughing up blood, your doctor may ask the following tests to be done:
- Computed tomography (CT) scan of the chest
- Chest X-ray
- Magnetic resonance imaging (MRI)
- Sputum examinations such as microscopy or culture to look for infections
- Lung scan
- Lung biopsy
- Bronchoscopy (a procedure in which a flexible tube is inserted through the nose or mouth to examine the lungs and airways)
- Blood counts
- Blood clotting test
- Pulmonary arteriography/angiography (a procedure to see the blood flow through the lungs)
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