Some Causes and Features of Hemoptysis
Cause | Common Features* | Tests† |
|---|---|---|
Use of anticoagulants (as used to treat pulmonary embolism, blood clots in the legs, or atrial fibrillation or to reduce the risk of clots after certain heart procedures) Use of medications that dissolve clots (thrombolytic medications, as used to treat a heart attack or stroke) | Sometimes bleeding from other sites, such as the nose or digestive tract (seen in stool) In people taking anticoagulants or thrombolytic agents Sometimes a family history of a blood clotting disorder | Blood tests that assess the blood's ability to clot |
A chronic cough and mucus production in people with a history of recurring infections | High-resolution CT of the chest Sometimes bronchoscopy | |
Bronchitis | Acute: A cough that may or may not produce sputum (productive or nonproductive) and sometimes symptoms of an upper respiratory infection (such as a stuffy nose) Chronic: A productive cough on most days of the month or for 3 months of the year for 2 successive years in people who smoke or in people known to have chronic obstructive pulmonary disease | Acute: A doctor's examination Chronic: A chest x-ray |
Certain long-lasting lung infections (tuberculosis, fungal infections, parasitic infections, or syphilis that affects the lungs) | Fever, cough, night sweats, and weight loss in people known to be exposed to the infection Often a history of a weakened immune system (immunosuppression) due to a disorder or medication | A chest x-ray CT of the chest Testing of sputum samples or samples of fluid from the lungs obtained with a bronchoscope |
A foreign object that has been present a long time and has not been identified | A chronic cough (typically in infants or young children) without symptoms of an upper respiratory infection Sometimes a fever | A chest x-ray Sometimes bronchoscopy |
Frothy, pink sputum, sometimes with blood streaks Shortness of breath that worsens while lying flat or that appears 1–2 hours after falling asleep Sounds suggesting fluid in the lungs, heard through a stethoscope Usually swelling (edema) of the legs | A chest x-ray Sometimes a blood test to measure a substance that is produced when the heart is strained (called brain natriuretic peptide, or BNP) Sometimes echocardiography | |
Fever, usually for one or more weeks A cough, night sweats, loss of appetite, and weight loss Poor dentition | A chest x-ray Sometimes CT or bronchoscopy | |
Night sweats and weight loss Usually in middle-aged or older adults with a history of heavy smoking | A chest x-ray CT Bronchoscopy | |
Fever, a feeling of illness, a productive cough, and shortness of breath Sudden appearance of chest pain when taking deep breaths Certain abnormal breath sounds, heard through a stethoscope | A chest x-ray | |
Pulmonary embolism (sudden blockage of an artery in a lung, usually by a blood clot) | Sudden appearance of sharp chest pain that usually worsens when inhaling Shortness of breath A rapid heart rate and a rapid breathing rate Often risk factors for pulmonary embolism, such as cancer, immobility (as results from being bedbound), blood clots in the legs, pregnancy, use of birth control pills (oral contraceptives) or other medications that contain estrogen, recent surgery or hospitalization, or a family history of the disorder | Specialized lung imaging tests, such as CT angiography or ventilation/perfusion (V/Q) scanning |
Pulmonary vasculitis (such as Goodpasture syndrome or granulomatosis with polyangiitis) | Fatigue and weight loss Sometimes blood in the urine Sometimes shortness of breath Sometimes swelling (edema) of the legs | A biopsy of kidney or lung tissue Blood tests to check for antibodies characteristic of the disorder (antiglomerular basement membrane antibodies, antineutrophil cytoplasmic antibodies) |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. | ||
† If people have hemoptysis, doctors always take a chest x-ray and measure oxygen levels in the blood with a sensor placed on a finger (pulse oximetry). | ||
CT = computed tomography. | ||