Coughing Up Blood (Hemoptysis): Causes, Appearance & Urgency
Hemoptysis (coughing blood) ranges from blood-streaked sputum to life-threatening massive bleeding. The appearance hints at the source.
Blood Appearance & Likely Origin
- Bright red, frothy: Fresh bleeding from airways/lungs (bronchitis, pneumonia, TB, pulmonary embolism, cancer).
- Dark red / coffee-ground: Older blood, possibly from lower airways or swallowed GI blood (GERD, ulcer, varices).
- Pink, frothy sputum: Pulmonary edema (heart failure, ARDS, altitude sickness).
- Blood-streaked mucus: Common in acute bronchitis, mild pneumonia.
- Massive hemoptysis (>100–200 mL/24h): Medical emergency—ruptured vessel, cavitary TB, aspergilloma, vascular malformation.
When to Seek Care
- Any hemoptysis warrants evaluation.
- Emergency: Large volume, dizziness, shortness of breath, chest pain, tachycardia.
- Urgent: Recurrent, >1 week, age >40, smoking history, weight loss.
Workup May Include
- Chest X-ray / CT
- Bronchoscopy
- CBC, coagulation, sputum culture/cytology
Never ignore coughing blood—even if it seems minor. Early diagnosis saves lives.
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