Should I Go to the ER for Coughing Up Blood?

Reviewed on 1/31/2022
A wadded up tissue with blood spots
You should see a doctor right away or go to a hospital’s ER if coughing up blood after trauma or injury to the chest, or you are also experiencing shortness of breath, signs of significant blood loss, large amounts of blood coughed up, unexplained coughing up blood, fatigue, blood is also in the urine or stool, having a tracheostomy, or if you also take blood thinners.

Coughing up blood (hemoptysis) can have many possible causes, some of which are serious, and some which may be of little concern. Blood that is coughed up often appears bright red and the sputum may look bubbly. 

13 Coughing Up Blood Emergency Signs & Symptoms

It is important to see a doctor for a proper diagnosis to rule out serious conditions that can cause coughing up blood. See a doctor right away or go to a hospital’s ER if coughing up blood is due to trauma or injury to the chest or is accompanied by any of the following:

  • Shortness of breath
  • Signs of significant blood loss 
  • Large amounts of blood coughed up (more than a one teaspoon)
  • Unexplained coughing up blood
  • Fatigue
  • Blood is also in the urine or stool
  • Having a tracheostomy
  • If you also take blood thinners (anticoagulants)

What Causes Coughing Up Blood?

Causes of coughing up blood include:

Uncommon causes of coughing up blood that can be serious or life-threatening include:

  • Acute bronchitis 
  • Other lung infections such as bacterial lung abscess and/or necrotizing pneumonia
  • Immunologic lung diseases, such as anti-glomerular basement membrane (anti-GBM; Goodpasture) disease, granulomatosis with polyangiitis, systemic lupus erythematosus (SLE), idiopathic pulmonary hemosiderosis, primary antiphospholipid antibody syndrome, Behçet syndrome, and microscopic polyangiitis
  • Penetrating, rather than blunt, trauma 
  • Pulmonary vascular diseases 
  • Chemotherapy and bone marrow transplantation
  • Acquired and iatrogenic trauma
  • Posterior arterial nosebleeds
  • Heart failure and heart valve disorders 
  • Right heart catheterization (i.e., pulmonary artery catheterization) 
  • Fistulas, such as fistulas between the aorta and the airway 
  • Medical interventions, including percutaneous or transbronchial lung biopsy, cryobiopsy, central vein venipuncture during pacemaker insertion, and ablative procedures for endobronchial masses

How Is Coughing Up Blood Diagnosed?

In addition to a patient history and physical examination, the cause of coughing up blood is diagnosed with tests such as: 

What Is the Treatment for Coughing Up Blood?

In mild cases, coughing up blood may go away on its own or when the underlying cause is treated. 

Smokers should stop smoking. Other treatments for coughing up blood may include:

Treatment for serious cases of coughing up large amounts of blood may require hospitalization which may include a stay in the hospital’s intensive care unit (ICU). 

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Reviewed on 1/31/2022
Image Source: iStock Images