Many things: Hemoptysis or coughing up blood from the lungs has several causes. Blood tinged sputum can happen from repeated, forceful coughing. Coughing up more than a tablespoon of blood usually comes from either a lung infection or cancer eroding into the lung blood vessels, a vascularized tumor in an airway or because of very high blood pressures in the lung (pulmonary hypertension) seen in mitral regurg.
Answered 5/11/2017
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