Hemoptysis

Hemoptysis is the spitting of blood that originated in the lungs or bronchial tubes. The patient’s history should help determine the amount of blood and differentiate between hemoptysis, pseudohemoptysis, and hematemesis. A focused physical examination can lead to the diagnosis in most cases. In children, lower respiratory tract infection and foreign body aspiration are common causes. In adults, bronchitis, bronchogenic carcinoma, and pneumonia are the major causes. Chest radiographs often aid in diagnosis and assist in using two complementary diagnostic procedures, fiberoptic bronchoscopy and high-resolution computed tomography, which are useful in difficult cases and when malignancy is suspected. The goals of management are threefold: bleeding cessation, aspiration prevention, and treatment of the underlying cause. Mild hemoptysis often is caused by an infection that can be managed on an outpatient basis with close monitoring. If hemoptysis persists, consulting with a pulmonologist should be considered. Patients with risk factors for malignancy or recurrent hemoptysis also require further evaluation with fiberoptic bronchoscopy or high-resolution computed tomography. In up to 34 percent of patients, no cause of hemoptysis can be found. Clinical recommendation Evidence rating Reference Patients with evidence of parenchymal disease should have high-resolution CT, and those with a mass should be considered for bronchoscopy. C Patients with normal chest radiograph, no risk f...

Most of the lung’s blood (95%) circulates through low-pressure pulmonary arteries and ends up in the pulmonary capillary bed, where gas is exchanged. About 5% of the blood supply circulates through high-pressure bronchial arteries, which originate at the aorta and supply major airways and supporting structures. In hemoptysis, the blood generally arises from this bronchial circulation, except when pulmonary arteries are damaged by trauma, by erosion of a granulomatous or calcified lymph node or tumor, or, rarely, by pulmonary arterial catheterization or when pulmonary capillaries are affected by inflammation. Etiology of Hemoptysis Primary Overview of Lung Tumors Lung tumors may be Primary Metastatic from other sites in the body Primary tumors of the lung may be Malignant (see table ) read more is an important cause in smokers ≥ 40 years, but metastatic cancer rarely causes hemoptysis. Cavitary Aspergillus infection is increasingly recognized as a cause but is not as common as cancer. Tuberculosis (TB) Tuberculosis is a chronic, progressive mycobacterial infection, often with an asymptomatic latent period following initial infection. Tuberculosis most commonly affects the lungs. Symptoms include... read more and other Overview of Pneumonia Pneumonia is acute inflammation of the lungs caused by infection. Initial diagnosis is usually based on chest x-ray and clinical findings. Causes, symptoms, treatment, preventive measures, and... read more History of present illness shoul...

Hemoptysis is the expectoration of blood from the lung parenchyma or airways. The initial step in the evaluation is determining the origin of bleeding. Pseudohemoptysis is identified through the history and physical examination. In adults, acute respiratory tract infections (e.g., bronchitis, pneumonia), bronchiectasis, asthma, chronic obstructive pulmonary disease, and malignancy are the most common causes. Tuberculosis is a major cause of hemoptysis in endemic regions of the world. Although tuberculosis rates are low in the United States, they are increased in persons who are homeless or who were born in other countries; consideration for testing should be made on an individual basis. Hemodynamic instability, abnormal gas exchange, cardiopulmonary comorbidities, and lesions at high risk of massive bleeding warrant inpatient evaluation. Chest radiography is recommended as the initial diagnostic test for hemodynamically stable patients with hemoptysis. Further evaluation with computed tomography with or without bronchoscopy is recommended in patients with massive hemoptysis, those with abnormal radiographic findings, and those with risk factors for malignancy despite normal radiographic findings. Clinical recommendation Evidence rating Reference Comments Chest radiography should be performed as part of the initial evaluation of patients with hemoptysis. C Recommendation from American College of Radiology consensus guidelines based on observational studies CT is suggested f...

Hemoptysis is the medical term for coughing up blood from the respiratory tract. It is a common finding in patients with lung cancer and other respiratory diseases. The act of coughing up blood is a finding that medical professionals must take seriously, as it could indicate that a serious medical condition is present. In this article, we will provide an overview of hemoptysis, including its causes, symptoms, and treatment options. What is Hemoptysis? Hemoptysis is the medical term for coughing up blood or bloody mucus from the lungs or bronchial tubes. This symptom can be indicative of various underlying respiratory issues, including infections, pulmonary embolism, bronchitis, or lung cancer, and warrants further medical evaluation to determine the cause and appropriate treatment. Causes Hemoptysis is a symptom of many underlying conditions, some of which are benign and others that are life-threatening. Some of the most common examples include: • • Tuberculosis • Bronchitis • Pneumonia • Bronchiectasis • Pulmonary embolism • Lung infection • Heart failure • Vasculitis • Using blood thinners While hemoptysis is not always indicative of a serious condition, it’s usually worth investigating further to determine the cause of bleeding. Diagnosis After it has been discovered that a patient is coughing up blood, the next step is to perform a This will usually involve a combination of a physical examination, imaging tests, and lab work. Some examples include: • • CT scan • Bronch...