Hemoptysis: Know the underlying causes of coughing up blood

By Dr. Vivek Saxena in Radiology , Interventional Radiology

Nov 07 , 2020 | 1 min read

Hemoptysis is when a patient coughs up blood or blood sputum from bronchi, larynx trachea or lungs. The most common underlying causes that can be detected with CT are:

  • Tuberculosis
  • Bronchiectasis
  • Chronic Bronchitis
  • Pneumonia
  • Fungal infections
  • Lung malignancy

*Massive Hemoptysis is the bleeding more than 300ml within 24 hours.

How is Hemoptysis evaluated?

The imaging modalities that are pertinent to the evaluation of hemoptysis are:

  • Chest Radiograph- It lateralize the bleeding with a higher degree of certainty and can often help in detecting underlying parenchymal and pleural abnormalities.


  • MDCT- Contrast-enhanced MDCT is capable of demonstrating the site of bleeding. It provides high-resolution angiographic studies of thoracic and upper abdominal vasculature that are useful prior to anticipated bronchial artery embolization or surgical intervention.


  • Thoracic aortography (Bronchial artery embolization)- It is the most effective therapy for controlling massive hemoptysis. In more than 90% of hemoptysis cases requiring intervention with arterial embolization or surgery, the bronchial arteries are responsible for bleeding.

Dr. Vivek Saxena says technical success has been achieved in more than 75-90% cases and recurrent blood is witnessed in approximately 20% cases, which is primarily due to non-recognition of a nonbronchial systemic collateral or pulmonary cause of hemoptysis.