Coughing up blood (haemoptysis)

 

Get medical help promptly

Even a few small spots or streaks of blood in sputum need an urgent GP appointment or advice from NHS 111.

Call 999 or go to A&E immediately if you cough up more than a few spots or streaks, or cough blood with difficulty breathing, a very fast heartbeat, or chest or upper-back pain. Do not drive yourself. Do not wait for a routine appointment.

 

What is haemoptysis?

Haemoptysis means coughing up blood from the airways or lungs. It may appear as blood-streaked mucus or more obvious bleeding. Possible causes include a severe cough, infection and bronchiectasis. A blood clot in the lungs or lung cancer can also cause it, so it should always be checked.

 

How is it investigated?

The first priority is assessing the bleeding and whether emergency care is needed. Tell the clinician how much blood you have seen, whether it is recurring, and about associated symptoms and medicines.

NICE recommends a suspected lung cancer pathway referral for people aged 40 or over with unexplained haemoptysis. This is a precaution to investigate promptly, not a diagnosis of cancer. Assessment may include chest imaging; where cancer is suspected, further tests can include CT, bronchoscopy or tissue sampling, selected for the individual.

 

How is it treated?

Treatment depends on the cause and severity of bleeding. It cannot safely be chosen from the symptom alone. Significant bleeding needs hospital assessment and control of the bleeding as well as investigation of its cause. Your clinical team will explain the appropriate treatment and follow-up.

 

Follow-up

Seek further urgent advice if bleeding recurs, increases or you develop other concerning symptoms, even after an earlier assessment.

Clinic contact details — for planned follow-up after urgent needs have been addressed.

 

Sources and further information

NHS: coughing up blood and urgent advice

NICE NG12: recognition and referral for suspected cancer

NHS: investigations when lung cancer is suspected

General information for adults; investigation and treatment are tailored to you.