Yesterday I had a very interesting conversation with a well-established patient. We had been following an abnormal cat scan of the chest which, for the most part was stable. The usual discussion in the exam room was undertaken about new problems, hospitalizations and visits to the emergency rooms. At the end of the conversation I asked if there were any new problems. The patient calmly said, “no, I’m ok except for this blood I have been coughing up”. The conversation then took a screeching turn with questions about the blood. Surprisingly, the patient did not seem overly concerned.
Let me set the record straight for all the readers out there. Coughing up blood is never normal and should never be consider something to keep to yourself instead of notifying you doctor. In this case the patient had been coughing blood for about two weeks but never called the office.
Hemoptysis, which is the medical term for coughing up of blood which originates in the lower airways or the lungs is a serious symptom. It is never normal. There are some causes for hemoptysis that are less serious than others.
However, I advise that you never keep this symptom to yourself even if the bleeding stops. Keep in mind that the most common causes of hemoptysis in the US are cancer, TB, pneumonia, bronchitis and bronchiectasis. The appropriate test and observations are needed for all of these possibilities. Talk to your doctor and be sure you get the needed work-up.
