Causes, Diagnosis, and Treatment of Hemoptysis

Older man coughing into napkin

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Hemoptysis is the medical term for coughing up blood. This can include just a small amount of blood in your sputum (spit) or straight blood coming from the respiratory tract or lungs. To qualify as true hemoptysis, however, the blood must be determined to have actually come from the respiratory tract rather than the mouth, stomach, esophagus, or nasal passageways.

Massive hemoptysis is a term that may be used to describe coughing up large amounts of blood which may be life-threatening.


There are many causes of hemoptysis. Some causes include underlying disease or other illness. Sometimes hemoptysis can be caused by medical testing or procedures such as a bronchoscopy. Tonsillectomy or even dental work can cause blood-tinged sputum but this is not true hemoptysis. Other known causes of hemoptysis include:

  • the aspiration (inhaling) of food or other substances into the lungs
  • a blood clot in the lungs (also called a pulmonary embolism)
  • fluid in the lungs (also called pulmonary edema)
  • infections of the lungs including pneumonia (very common)
  • cystic fibrosis
  • acute bronchitis (common)
  • chronic bronchitis (including chronic bronchitis caused by cigarette smoking)
  • tuberculosis
  • lung cancer
  • systemic lupus erythematosis
  • pulmonary hypertension (rare)
  • trauma to the chest or lungs which affects the blood vessels of the lungs or respiratory tract
  • vasculitis (inflammation of the blood vessels in the lungs or respiratory tract)
  • bronchiectasis (a condition in which the integrity of the airways is impaired as the result of previous infections or damage to the airways)

Small amounts of blood-tinged sputum can also occur when the back of the throat becomes irritated by frequent or violent coughing. The most common causes of hemoptysis in children are lower respiratory infections and inhaling a foreign object into the lungs (aspiration).


As previously mentioned, true hemoptysis is blood that is coming from the respiratory tracts or lungs, it must be differentiated from blood that appears in the mouth or throat but originates in the nasal passageways, esophagus or stomach.

Except for very small amounts of blood-tinged sputum after certain medical procedures (such as a tonsillectomy or dental work) or from a bad cough, hemoptysis should almost always be evaluated by a physician. Your doctor will ask you about your symptoms and medical history as well as conducting a physical examination.

Some of the following laboratory tests or medical procedures may also be helpful in identifying the root cause of hemoptysis:

  • sputum testing
  • bronchoscopy
  • chest x-rays
  • CT scan of the lungs
  • blood tests (to determine how much blood has been lost or if there are any underlying disorders that may make an individual more susceptible to bleeding)


Massive hemoptysis is a medical emergency. You should call 911 or go to the emergency room any time you are coughing up more than a teaspoon or two of blood. You should also call 911 if you are coughing up blood and have symptoms such as difficulty breathing, dizziness, feeling light-headed, blue-colored lips, or chest pain.

Treating hemoptysis depends on the root cause. For example, pneumonia may be treated by combining antibiotics, rest, or in severe cases hospitalization.

Blood-tinged sputum that is the result of violent coughing may be treated at home with cough suppressant medications and monitoring.

Bloody sputum that is the result of a medical procedure such as a bronchoscopy with biopsy may also be monitored at home and should resolve on its own. Other causes of hemoptysis, such as cancer or cystic fibrosis may require more extensive treatments. Your doctor will tailor a specific treatment plan based on your individual circumstances.

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Article Sources

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  • Coughing up blood. Medline Plus.

  • Hemoptysis: Diagnosis and Management. American Family Physician.

  • What is Bronchiectasis? National Heart Lung and Blood Institute.