Coughing up blood can be frightening, but it isn’t always a sign of a serious medical emergency.
Many cases can be the result of a persistent cough or a chest infection that often clears up on its own, but it should always be checked by a doctor.
However, there are times when coughing up blood (or haemoptysis) can be a symptom of a more serious condition.
For example, coughing up brown blood, or blood that looks like it contains coffee grounds, could be a sign that you're bleeding from your digestive system.
Coughing up frothy, pink sputum could be a sign of heart failure.
If you experience any of these conditions, or you’re coughing up significant amounts of blood or struggling to breathe you should call an ambulance or go straight to your nearest emergency room.
Always see a doctor
It’s important to see a doctor if you’re coughing up blood because they'll need to rule out if it’s caused by a serious medical condition like a pulmonary embolism, a lung abscess or heart failure.
They'll also be able to find out if it’s being caused by other medical conditions such as a chest infection or a long-lasting cough, and offer you advice on further management.
Questions to ask yourself if you’re coughing up blood
If you’re coughing up blood, you should see a doctor and not try to diagnose the cause yourself.
But if you’d like to know more about the possible causes, you may find that it helps to ask yourself the following questions — in addition to seeking medical attention.
Are you coughing a lot?
If you cough up blood and you also have a cough that produces mucus or sputum, you might have a chest infection like pneumonia, tuberculosis or bronchitis. This is where bacteria or other germs infect the tissues in your lungs and airways.
Chest infections can also cause symptoms like a stuffy or runny nose, a sore throat, headaches, muscle aches or a high temperature. Around 70% to 90% of adults who cough up blood are thought to have a chest infection.
Most chest infections clear up in 7 to 10 days, but some people develop chronic or long-term chest conditions like chronic bronchitis, which can last for several months or sometimes years.
A doctor will help you to rule out an underlying medical condition, and try and reduce the risk of any further complications.
They may order an X-ray of your chest to help them diagnose your condition. If they think that you have a chest infection that’s caused by a bacterial infection, they may also prescribe a course of antibiotics.
Are you wheezy, short of breath or very tired?
If you’re coughing up blood and you’re also wheezy or short of breath, you may have a condition called bronchiectasis. This is where the airways in your lungs become widened and inflamed.
Bronchiectasis is often caused by a severe form of pneumonia or tuberculosis. It can also be linked to conditions that affect your immune system, inflammatory bowel disease, asthma or sarcoidosis — where patches of red and swollen tissue develop in organs, usually the lungs and skin.
About 50% of cases are also idiopathic, which means that doctors can't identify a clear cause.
The symptoms of bronchiectasis vary from person to person, but some common signs include:
- frequent chest infections
- feeling very tired or finding it hard to concentrate
- problems with your sinuses
Bronchiectasis can increase your chances of developing a long-term cough, and it’s known to make some people cough up blood.
Once the condition develops, it can’t be cured, but a doctor can help you to manage it. They may give you special breathing exercises that will help you to clear your airways.
A doctor may also prescribe antibiotics to treat flare ups and reduce your chances of developing a chest infection.
Is the blood darker than usual?
If you’re coughing up blood that’s dark, or blood that looks like it might contain bits of food or coffee grounds, you may have a digestive condition like a stomach ulcer or esophageal varices. This is where blood vessels in the lower part of your oesophagus become enlarged and bleed.
Bleeding from your digestive tract is always a serious medical emergency and you should go straight to hospital.
Are you coughing up frothy, pink or blood-streaked sputum?
Sputum containing streaks of blood often comes from the lungs, but coughing up frothy pink sputum can also be a symptom of heart failure.
Heart failure is a serious condition that needs immediate medical attention. It normally occurs when the heart becomes too weak or stiff to pump blood around the body.
If you’re diagnosed with heart failure you may need heart surgery, or be fitted with a medical device that will help to manage the rhythm of your heart. Your doctor may also prescribe medications to help you control your condition.
Do you have night sweats or unexpected weight loss?
Night sweats, loss of appetite, coughing up blood and sudden weight loss can all be symptoms of tuberculosis, lung cancer or a lung abscess (a pus-filled cavity in the lungs).
Tuberculosis (or TB) is a bacterial chest infection that normally affects your lungs and can be treated with the right course of antibiotics.
Lung cancer is among the most common forms of cancers and can be fatal. Treatment will depend on the type of cancer you have, but it it’s often treated with surgery, chemotherapy or radiotherapy.
A lung abscess can develop for a number of reasons, but most lung abscesses occur when you breathe in bacteria that normally live in your mouth. They can be treated with a course of antibiotics or drained using a surgical procedure.
What else can make you cough up blood?
Some of the less common causes of coughing up blood can include:
- a blot clot in the lungs (a pulmonary embolism)
- a clotting disorder or a condition that inflames the blood vessels in your lung, like Goodpasture syndrome
It’s important to note that many conditions can cause this to happen. For example, a severe nosebleed could cause you to spit out blood when you cough.
But if you’re coughing up large amounts of blood or having difficulty breathing, you should seek medical attention immediately.
If you have symptoms that aren’t mentioned here, you could also try using our Self-Assessment Tool.
- coughing up blood can often be the result of a persistent cough or a chest infection, but it should always be checked by a doctor
- About 50% of cases are idiopathic, which means that doctors can't identify a clear cause
- coughing up brown blood, or blood that looks like it contains coffee grounds, could be a sign that you're bleeding from your digestive system — this is a medical emergency
- if you’re coughing up blood and you’re also wheezy or short of breath, the airways in your lungs may have become widened and inflamed (known as bronchiectasis)
- night sweats, loss of appetite, coughing up blood and sudden weight loss can all be symptoms of tuberculosis, lung cancer or a lung abscess