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What is Hemoptysis?

Hemoptysis means coughing up blood. It is a symptom of bleeding somewhere in the respiratory tract, including the nose, mouth, throat, trachea, or the lungs. The seriousness of the hemoptysis depends on the cause of the bleeding.

Coughing up blood can be a frightening experience—but it is not necessarily serious.
Blood-tinged mucus in a person who is healthy and does not smoke may be due to a mild infection and is generally no cause for concern. In fact, the most common cause of hemoptysis is the least serious – a broken small blood vessel caused by coughing associated with an upper respiratory infection (cold) and/or acute bronchitis. However, if you are a smoker or are otherwise at risk for lung disease, hemoptysis may be a sign of serious illness, including cancer.

You should notify their doctor immediately if you are coughing up blood. Your doctor will want to perform a thorough exam and review medications that you may be taking to determine the cause of the bleeding.

Coughing up blood from the lungs is sometimes confused with bleeding from the gastrointestinal tract. You may have vomiting with blood, which is known as hematemesis.

What Causes Hemoptysis?

There are many disorders that can cause hemoptysis, including:

  • Bronchitis
  • Bronchiectasis
  • Coagulation problems in the blood
  • Congenital defects in blood vessels in the lungs
  • Drug Use—especially cocaine
  • Heart disease
  • Inhaling a foreign body
  • Lung Cancer
  • Medications—especially anticoagulants
  • Pneumonia
  • Pulmonary embolism
  • Trauma to the chest
  • Tuberculosis

Sometimes hemoptysis happens accidentally as the result of a medical procedure. This is known as iatrogenic hemoptysis and may occur during a bronchoscopy, following a biopsy of lung tissue, or some other type of procedure.

In upwards of 40% of cases of hemoptysis the underlying cause cannot be determined—even after extensive diagnostic tests, including a bronchoscopy. Generally this type of bleeding, known as cryptogenic hemoptysis, is mild with a good prognosis (final outcome) for most people.

How is Hemoptysis Diagnosed?

It is important for a physician to diagnose the cause of hemoptysis. To determine a diagnosis, the physician will take a detailed medical history, and perform laboratory tests and a chest x-ray. The tests may also include a bronchoscopy, CT scan, or MRI depending on the nature of the hemoptysis and likelihood of cancer. If there is a possibility that the cause of the bleeding is related to a blood vessel disorder, a pulmonary angiography may also be done.

How is Hemoptysis Treated?

Treatment for hemoptysis is directed at the underlying cause—for example, antibiotics for pneumonia and other lung infections, surgery to treat trauma or remove a foreign body, and surgery and chemotherapy for lung cancer. If the cause cannot be determined (cryptogenic hemoptysis), the physician will likely monitor the condition and further testing may be recommended if there is no improvement.

Last modified on: 8 September 2017