Most are caused by pulmonary oedema due to acute heart failure. In addition to coughing up shortness of breath and coughing up pink frothy sputum, patients are usually accompanied by profuse sweating, pallor, cyanosis of the lips, irritability and in severe cases, confusion and shock. If you develop a sudden onset of shortness of breath, pink frothy sputum or other symptoms of pulmonary oedema, you should seek immediate medical attention in the emergency department.