Coughing up blood refers to blood or blood-streaked mucus brought up by coughing. It can occur alone or with other symptoms. The information below is general and intended to help understand possible causes and when to seek medical assessment.
Amounts can range from small blood-streaked sputum to life‑threatening, large-volume bleeding. Hemoptysis may occur with cough, fever, shortness of breath, chest pain, unintended weight loss or night sweats. Determining the bleeding source and severity requires clinical assessment.
Causes span infections (bronchitis, pneumonia, tuberculosis), structural lung disease such as bronchiectasis, pulmonary embolism, lung tumors, trauma, and bleeding disorders. Bleeding from the upper airway (nose, mouth or gums) or the digestive tract can sometimes be mistaken for hemoptysis. Use of anticoagulant medications or systemic conditions that affect clotting may also contribute.
Immediate emergency evaluation is appropriate for large amounts of blood, worsening shortness of breath, severe chest pain, fainting or loss of consciousness, rapid heartbeat, or low blood pressure. If any of these occur, go to the nearest emergency department or call local emergency services.
Initial assessment includes history and physical exam followed by tests as needed: chest X‑ray or CT scan, blood tests, and bronchoscopy in selected cases. Pulmonology (respiratory medicine) is commonly the first specialist involved. Ear, Nose & Throat (ENT) clinicians evaluate suspected upper airway sources; thoracic (chest) surgeons are consulted for surgical management; infectious disease specialists manage confirmed infections. Primary care clinicians often coordinate first‑line evaluation and referral.
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