It seems dramatic, but a bit of blood needn’t have a nasty twist

You can really rely on rubbish movies to be filled with lots of clichés.

If you see a gun in act one, then it’s probably going to be used at some point.

If someone opens a medicine cabinet door then you can bet the baddie is waiting in the mirror when they close it again.

And if a character coughs up blood then you know they’re definitely not very well.

I don’t know about the other two, but I had someone in last week who’d been coughing up blood, or haemoptysis as it’s more formally known.

It wasn’t a huge amount – if someone coughs up a lot then they should call an ambulance immediately – but it was persistent. There are a number of causes of haemoptysis, and some of them can indeed be serious.

It used to be a common sign of tuberculosis, which at one stage was a death sentence but these days it’s much rarer, and can be treated.

There are other infections which can bring it on, too, such as acute bronchitis, or pneumonia. A pulmonary embolism is a clot in the lungs, which most often comes after deep vein thrombosis in the leg.

A blood vessel in the lungs is blocked and there can be bleeding, usually associated with chest pain and shortness of breath.

In younger people or non-smokers something like lung cancer wouldn’t be my first thought, but in folk over 50 who are smokers then I’d generally order some tests to rule it out. Blood in the sputum may also be a sign of heart failure, but other signs of this are usually obvious.

This condition can cause a build-up of fluid in the lungs, and as well as feeling breathless, there can be a frothy, bloodstained sputum. In younger children coughing up blood can indicate that they’ve breathed in something which has damaged the airway – like a peanut or a piece of LEGO.

There are other rare conditions, which can cause inflammation in the lung and bleeding at times.

All of these causes can be treated in their own way – it just depends what it is. The important thing is that a doctor has a look.

Occasionally we might not find a reason why someone is coughing up blood, even after tests. It comes and goes and we’re none the wiser.

Not a particularly satisfying ending, that one – a bit like a rubbish movie.