Coughing pink foamy sputum is often a symptom of acute cardiac insufficiency that causes acute pulmonary edema, so any disease that causes acute cardiac insufficiency can present with coughing pink foamy sputum. It is common in cardiovascular diseases such as coronary heart disease, dilated cardiomyopathy, mitral stenosis, hypertensive heart disease, and rheumatic heart disease, and may also suggest acute pulmonary embolism, because acute cardiac insufficiency caused by these diseases causes a dramatic decrease in cardiac output and a decrease in the amount of blood returned to the heart causing severe pulmonary stasis. The occurrence of pulmonary stasis causes a rise in the hydrostatic pressure of pulmonary capillaries, which leads to an increase in blood exudation from the capillaries into the alveoli and respiratory fine bronchi, and the formation of pink foamy sputum through the secretions of the fine bronchi and bronchial mixed airways, which is expelled through the coughing action. Therefore, coughing up pink foamy sputum often indicates a more urgent state, and treatment should be immediately directed at improving cardiac function, including appropriate treatment such as dilating peripheral blood vessels, reducing cardiac load, and enhancing myocardial contractility.