Pink sputum in a patient with cough can indicate congestive heart failure. Which color sputum is associated with CHF?

• A. Pink
• B. Green
• C. Yellow
• D. White

Answer: (A)

Pink, frothy sputum is a classic sign of pulmonary edema from congestive heart failure. When the left side of the heart fails, pressure backs up into the pulmonary capillaries and fluid leaks into the air spaces of the lungs. This edema fluid often mixes with a small amount of blood, giving the sputum a pink color and a frothy texture as air bubbles through the fluid. It signals fluid overload in the lungs rather than infection. By contrast, green or yellow sputum usually points toward infection with pus, and white sputum can occur with viral infections or noninfectious causes. So pink sputum reflects edema and blood-tinged alveolar fluid due to CHF.