Coughing Up Blood (Hemoptysis): Causes and When to Seek Care

Hemoptysis (coughing blood) ranges from blood-streaked sputum to massive bleeding. Always warrants medical evaluation.

Common causes:

• Respiratory infections: Pneumonia, bronchitis, TB.
• Chronic lung disease: Bronchiectasis, COPD, cystic fibrosis.
• Lung cancer: Especially central tumors eroding vessels.
• Pulmonary embolism: Sudden dyspnea, pleuritic pain, hemoptysis.
• Cardiac: Mitral stenosis, left heart failure (pulmonary edema).
• Vasculitis: Granulomatosis with polyangiitis, Goodpasture syndrome.
• Bleeding disorders: Anticoagulants, hemophilia, vWD.
• Trauma, foreign body, PAVM.

Red flags (seek emergency care): >100 mL blood, dyspnea, hemodynamic instability, chest pain, dizziness.

Diagnosis: CXR, CT angiography, bronchoscopy. Treatment targets underlying cause.