I'm Coughing Up Blood β What Should I Do?
Coughing up blood (hemoptysis) can be frightening. Here is what you need to know and what to do.
Coughing up blood always needs medical evaluation, but the amount and context matter. It is important to distinguish between:
- True hemoptysis β coughing up blood that comes from the lungs or airways
- Pseudohemoptysis β blood from the nose or mouth that you cough up, which is usually less serious
- Hematemesis β vomiting blood from the stomach, which looks different
- Common causes include:
- Bronchitis β a severe cough that irritates the airways; this is the most common cause of small amounts of blood
- Pneumonia β lung infection can cause blood-tinged phlegm
- Nosebleed β blood dripping down the back of the throat
- Gum disease or dental bleeding β blood from the mouth mixed with saliva
- Pulmonary embolism β a blood clot in the lung (serious)
- Lung cancer β possible, especially in smokers over 40
- Throat or laryngeal cancer β less common cause
What to Do
- If you cough up blood:
- Do not panic β small amounts of blood (streaks in phlegm) are common with a bad cough
- Note the amount β is it streaks, teaspoon-sized, or more?
- Note the color β bright red, dark, or rust-colored?
- Note how often it happens
- See a doctor promptly if:
- You cough up a significant amount of blood (more than a few streaks)
- You cough up blood more than once
- You have chest pain, fever, or shortness of breath
- You are a smoker over age 40
- You have unintentional weight loss
- You have a persistent cough
- Seek emergency care if:
- You cough up more than a tablespoon of blood
- You have trouble breathing
- You feel lightheaded or dizzy