Coughing up blood (hemoptysis) is a symptom that can have many causes, some minor and some serious. It’s important to seek prompt medical evaluation, especially if you’re coughing up blood, if the amount is large, or if it’s accompanied by other concerning symptoms. What could be happening

• Common, less urgent causes:
  • Severe or prolonged coughing leading to irritation or tiny blood vessels breaking
  • Chest infections such as bronchitis or pneumonia
  • Bronchiectasis or chronic lung conditions
• Potentially serious causes:
  • Lung infections such as tuberculosis or fungal infections
  • Pulmonary embolism (blood clot in the lung)
  • Lung cancer or other tumors
  • Inflammation of blood vessels in the lungs or certain autoimmune diseases
  • Bleeding disorders or effects from blood-thinning medications
  • Trauma to the chest or recent medical procedures

When to seek urgent care

• If you are coughing up a large amount of blood (e.g., more than a few tablespoons) or you see bright red blood
• If you have chest pain, fainting, shortness of breath, or significant wheezing
• If you have risk factors for serious conditions (e.g., a history of cancer, recent immobilization or surgery, or a known blood clot)
• If coughing up blood has persisted for more than a day or two or if you’re uncertain about the cause

What to do now

• Do not ignore the symptom. Contact a healthcare professional or go to urgent care/er, especially if any red-flag signs are present.
• Note accompanying symptoms: fever, weight loss, night sweats, coughing duration, the color and amount of blood, and any medications (including blood thinners) or medical history.
• Avoid lying flat; sit upright to help breathing and coughing up mucus more easily if advised by a clinician.
• Bring a list of current medications and any recent procedures or infections to your appointment.

Possible tests a clinician may order

• Physical exam and medical history review
• Chest imaging (usually a chest X-ray; CT scan if needed)
• Sputum analysis or cultures
• Blood tests to assess clotting and identify infection or inflammation
• Bronchoscopy in certain cases to visualize the airways and identify the bleeding source

Important cautions

• Hemoptysis can indicate life-threatening conditions; timely evaluation is essential to determine the cause and appropriate treatment.
• If you’re currently experiencing severe shortness of breath, chest pain, fainting, or confusion, seek emergency care immediately.

If you’d like, share your age, any existing health conditions, recent infections or injuries, smoking status, and how long the coughing up blood has been happening. This can help tailor guidance and indicate how urgently to seek care.