Cancer Lung Cancer Living With Print When Is Coughing Up Blood an Emergency? Medically reviewed by Medically reviewed by Michael Menna, DO on November 18, 2019 Dr. Michael Menna is a board-certified, active attending emergency medicine physician at White Plains Hospital in White Plains, New York. Learn about our Medical Review Board Michael Menna, DO on November 18, 2019 Written by facebook Written by Lynne Eldridge, MD Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time." Learn about our editorial policy Lynne Eldridge, MD More in Lung Cancer Living With Non-Small Cell Small Cell Causes & Risk Factors Symptoms Treatment Diagnosis Support & Coping In This Article Table of Contents Expand Overview Causes Seeking Help Diagnosis Treatments In Children A Word From Verywell View All Back To Top Coughing up blood, otherwise known as hemoptysis, can be very frightening. It can also be confusing at first. Is the blood truly coming from your lungs or could it be from a nosebleed, your esophagus, or from your stomach? While hemoptysis is the most specific symptom of lung cancer, it is more often due to a benign cause. Let's look at the possible causes, what may be done to diagnose the underlying problem, and the possible treatment options. We will also discuss when coughing up blood can be an emergency, but coughing up even small amounts of blood can be dangerous. Coughing up a third of a cup of blood has a mortality rate of around 30 percent. If you have coughed up a teaspoon or more of blood, don't wait to make an appointment. Call 911 now. Overview Hemoptysis may occur when there is bleeding in the throat, the trachea, or in the large or small airways of the lungs (the bronchi or the bronchioles). Many people describe their symptoms as spitting up blood-streaked mucus. Blood that is coughed up is often mixed with phlegm and can have a bubbly appearance. It is important to make a distinction between coughing up blood and blood that is brought up through your mouth from other regions of your body. “Pseudohemoptysis” is a term that describes spitting up blood that doesn’t come from your lungs or bronchial tubes. "Hematemesis" is a term that refers to blood that comes from your esophagus and stomach (throwing up blood). Causes Illustration by Nusha Ashjaee, Verywell If you cough up blood it doesn’t necessarily mean you have lung cancer. There are many conditions that can cause this symptom—and only one of these is lung cancer. Hemoptysis is the only symptom in only 7 percent of people diagnosed with lung cancer, and it's considered the symptom most specific for the diagnosis. But since the outlook for lung cancer is better the earlier it's diagnosed, it is important to consult your doctor as soon as possible. The most common causes of coughing up blood are irritation in the airways from coughing or an infection. Some possible causes of blood-streaked sputum include: Inflammation and irritation of the airways from repeated coughingBronchitisBronchiectasisLung cancerPneumoniaPulmonary edemaBlood clots in the lungs (pulmonary embolus)—With pulmonary emboli, people often have pain, redness, or swelling in their calves due to deep vein thrombosis.Tuberculosis—This is the most common cause of coughing up blood worldwide, but less common in the United States.Inhalation of a foreign bodyBleeding disorders—These can be inherited or due to medications or supplements that increase the time it takes for your blood to clot. Seeking Help Coughing up blood can quickly become an emergency. Coughing up more than one teaspoon of blood is considered a medical emergency. Coughing up 100cc of blood—only 1/3 of a cup—is called massive hemoptysis and has a mortality (death) rate of over 50 percent. Don't try to drive yourself or have someone else drive you to the hospital—call 911. You should also call 911 immediately if you experience chest pain, shortness of breath, or lightheadedness, even if you cough up just a trace of blood. The problem is that coughing up blood can quickly cause airway obstruction and aspiration of the blood into your lungs. Diagnosis If you cough up blood—even a very slight amount just once—it is important to make an appointment to see your physician. If possible, bring a sample of what you have been coughing up to your doctor’s appointment. Wrapping the sample in plastic wrap or wax paper can preserve the sample better than wrapping it in tissue. Your doctor will ask you several questions in addition to performing a careful physical exam. Some of these include: How long has this been happening?When did it begin?Did it occur while you were eating?How much blood did you cough up?Was the blood mixed with mucus?What other symptoms have you been experiencing? For example, a persistent cough, allergy symptoms, shortness of breath, hoarseness, wheezing, unexplained weight loss, or fatigue.Have you had any episodes of choking?Do you, or have you ever, smoked?What medications are you taking (including any herbal supplements or over-the-counter medications)?What other medical conditions do you have?Has anyone in your family had bronchitis, bleeding disorders, lung problems, or lung cancer? Depending upon the amount of blood you are coughing up, your doctor will first want to make sure your airway is okay to prevent aspiration (breathing in the contents that are present in your mouth) and control any active bleeding. He/she will then recommend tests to determine the cause. Possible tests may include: Lab tests to check your blood counts and look for any reason for bleedingA chest X-ray to look for infection of any evidence of a tumorA CT scan of your chestA bronchoscopy to check for foreign bodies or evaluate your airways for a tumor (in a bronchoscopy, a flexible tube is inserted through your mouth and down into your bronchi) It's important to be your own advocate and to keep asking questions if an answer is not found. Lung cancers are often missed on regular chest X-rays and further testing is needed, including a chest CT scan. If you aren't getting answers, consider getting a second opinion. Treatments Treatment will depend on the cause of your symptoms as well as the amount of blood you have been coughing up. Remember that if you only cough up blood once, and even if it is a small amount, it is still extremely important to see your doctor as soon as possible. If you are actively bleeding, a CT scan is usually the imaging test of choice to evaluate bleeding. Most bleeding in the airways stems from the bronchial arteries, and bronchial artery embolization (essentially putting a clot in the artery) is often an effective treatment. If your doctor is suspicious that you may have lung cancer, you can learn more about how lung cancer is diagnosed, what you may expect, and your possible risk factors for lung cancer (it goes far beyond smoking and 10 to 15 percent of lung cancer diagnoses occur in never smokers). Don't dismiss the chance that you could have lung cancer until the diagnosis has been ruled out. Lung cancer occurs in never-smokers. It occurs in young adults. And it is almost as common in women as in men. Unfortunately, the average time between the onset of symptoms and diagnosis of lung cancer is 12 months —a time during which treatment can often make a difference in the outcome of the disease. In Children Coughing up blood in children tends to have different causes than the same symptom in adults. The most common causes are infections, such as pneumonia, bronchitis, and tuberculosis. Roughly a third of the time a cause cannot be determined and the symptom goes away without finding a cause. Underlying heart disease is the second most common cause of hemoptysis in children. A Word From Verywell Coughing up blood can be a frightening symptom, as the causes can be as mild as airway irritation from coughing, or as serious as lung cancer or a blood clot in the lungs. Even small amounts of bleeding into the lungs can be dangerous, due to the risk of aspiration (and asphyxiation). Coughing up only a teaspoon of blood is considered a medical emergency. While frightening, even with active bleeding there is much that can be done. Bronchial artery embolization is often very effective in what could otherwise be a life-threatening situation. While coughing up blood is the first symptom in only 7 percent of lung cancers, it's important to rule out this possibility in adults regardless of risk factors. As with other cancers, the earlier a lung cancer is diagnosed, the greater the chance of a cure. Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Walter FM, Rubin G, Bankhead C, et al. 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Eur Respir J. 2015;46 (suppl 59):PA1239. doi:10.1183/13993003.congress-2015.PA1239 Sim J, Kim H, Lee H, Ahn K, Lee SI. Etiology of hemoptysis in children: a single institutional series of 40 cases. Allergy Asthma Immunol Res. 2009;1(1):41-4. doi:10.4168/aair.2009.1.1.41 Additional Reading Bannister, M., and K. Ah-See. Evidence-Based Management of Haemoptysis by Otolaryngologists. Journal of Laryngology and Otology. 2015. 129(8):807-11. Simon, D., Aronoff, S., and M. Del Vecchio. Etiologies of Hemoptysis in Children: A Systematic Review of 171 Patients. Pediatric Pulmonology. 2017. 52(2):255-259. Yendamuri, S. Massive Airway Hemorrhage. Thoracic Surgery Clinics. 2015. 25(3):255-60. Continue Reading