Hemoptysis: Difference between revisions

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==Overview==
'''Hemoptysis''' or '''haemoptysis''' (see [[American and British English spelling differences#Simplification of ae .28.C3.A6.29 and oe .28.C5.93.29|American and British spelling differences]]) is the expectoration ([[cough]]ing up) of [[blood]] or of blood-stained [[sputum]] from a source below the vocal cords such as the [[bronchi]], [[larynx]], [[vertebrate trachea|trachea]], or [[lungs]] (e.g. in tuberculosis or other respiratory infections).  It is not the same as [[hematemesis]], which refers to [[vomit]]ing up blood.


'''Hemoptysis''' or '''haemoptysis''' (see [[American and British English spelling differences#Simplification of ae .28.C3.A6.29 and oe .28.C5.93.29|American and British spelling differences]]) is the expectoration ([[cough]]ing up) of [[blood]] or of blood-stained [[sputum]] from the [[bronchi]], [[larynx]], [[vertebrate trachea|trachea]], or [[lungs]] (e.g. in tuberculosis or other respiratory infections).  
==Pathophysiology==
In most cases of hemoptysis, bleeding comes from the bronchial arteries as opposed to the pulmonary arteries.


It is not the same as [[hematemesis]], which refers to [[vomit]]ing up blood.
==Natural Hisotry, Compilcations, Prognosis==
== Overview ==
Although uncommon, massive hemoptysis may be fatal.
* Hemoptysis is defined as coughing up blood from a source below the vocal cords.
* In most cases of hemoptysis, bleeding comes from the bronchial arteries as opposed to the pulmonary arteries.
* Massive hemoptysis may be fatal, although uncommon.
* 20% of the cases of hemoptysis are idiopathic in nature.
==Causes==
==Causes==
This can be due to [[bronchitis]] or [[pneumonia]] most commonly, but also to [[lung cancer|lung neoplasm]] (in smokers, when hemoptysis is persistent), [[aspergilloma]], [[tuberculosis]], [[bronchiectasis]], [[coccidioidomycosis]], [[pulmonary embolism]], or [[Bubonic plague|pneumonic plague]].  
This can be due to [[bronchitis]] or [[pneumonia]] most commonly, but also to [[lung cancer|lung neoplasm]] (in smokers, when hemoptysis is persistent), [[aspergilloma]], [[tuberculosis]], [[bronchiectasis]], [[coccidioidomycosis]], [[pulmonary embolism]], or [[Bubonic plague|pneumonic plague]].  


Rarer causes include [[hereditary hemorrhagic telangiectasia]] (HHT or Rendu-Osler-Weber syndrome), or [[Goodpasture's syndrome]] and [[Wegener's granulomatosis]].
Rarer causes include [[hereditary hemorrhagic telangiectasia]] (HHT or Rendu-Osler-Weber syndrome), or [[Goodpasture's syndrome]] and [[Wegener's granulomatosis]].In children it is commonly due to a [[foreign body]] in the [[respiratory tract]].
 
In children it is commonly due to a [[foreign body]] in the [[respiratory tract]].


It can result from over-anticoagulation from treatment by drugs such as [[warfarin]].
It can result from over-anticoagulation from treatment by drugs such as [[warfarin]].
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The origin of blood can be known by observing its color. Bright red, foamy blood comes from the respiratory tract while dark red, coffee-colored blood comes from the [[gastrointestinal tract]].
The origin of blood can be known by observing its color. Bright red, foamy blood comes from the respiratory tract while dark red, coffee-colored blood comes from the [[gastrointestinal tract]].
20% of the cases of hemoptysis are idiopathic in nature.
==Complete List of Differential Diagnoses==  
==Complete List of Differential Diagnoses==  
* [[Actinomycosis]]
* [[Actinomycosis]]

Revision as of 11:59, 15 May 2012

Hemoptysis
ICD-10 R04.2
ICD-9 786.3
DiseasesDB 5578
MedlinePlus 003073

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Hemoptysis or haemoptysis (see American and British spelling differences) is the expectoration (coughing up) of blood or of blood-stained sputum from a source below the vocal cords such as the bronchi, larynx, trachea, or lungs (e.g. in tuberculosis or other respiratory infections). It is not the same as hematemesis, which refers to vomiting up blood.

Pathophysiology

In most cases of hemoptysis, bleeding comes from the bronchial arteries as opposed to the pulmonary arteries.

Natural Hisotry, Compilcations, Prognosis

Although uncommon, massive hemoptysis may be fatal.

Causes

This can be due to bronchitis or pneumonia most commonly, but also to lung neoplasm (in smokers, when hemoptysis is persistent), aspergilloma, tuberculosis, bronchiectasis, coccidioidomycosis, pulmonary embolism, or pneumonic plague.

Rarer causes include hereditary hemorrhagic telangiectasia (HHT or Rendu-Osler-Weber syndrome), or Goodpasture's syndrome and Wegener's granulomatosis.In children it is commonly due to a foreign body in the respiratory tract.

It can result from over-anticoagulation from treatment by drugs such as warfarin.

Cardiac causes like congestive heart failure and mitral stenosis should be ruled out.

The origin of blood can be known by observing its color. Bright red, foamy blood comes from the respiratory tract while dark red, coffee-colored blood comes from the gastrointestinal tract.

20% of the cases of hemoptysis are idiopathic in nature.

Complete List of Differential Diagnoses

Diagnostic workup

Laboratory Findings

Electrolyte and Biomarker Studies

Chest X Ray

MRI and CT

  • Chest CT scan to show focal bleeding

Other Diagnostic Studies

Treatment

  • Treat underling etiologies for minor hemoptysis
  • Special attention to airway, breathing and circulation
  • Administration of supplemental O2
  • Stablize hemodynamics
  • Cough suppression
  • Intubation

Acute Pharmacotherapies

Surgery and Device Based Therapy

  • Bronchoscopic balloon tamponade
  • Arteriography and embolization
  • Emergent thoracic surgery

External links

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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