All the information below can be referred to Harrisons text book of Medicine.
What is hemoptysis ?
Hemoptysis is the expectoration of blood from the
respiratory tract.
What can hemoptysis
be confused with?
Hematemesis and epistaxis
What are the causes
of Hemoptysis?
Tracheobronchial (Airway )
|
Parenchymal (Lungs)
|
Cardiogenic
|
Vascular
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Miscellaneous
|
Carcinoma (bronchogenic, endobronchial,
metastatic)
|
Tuberculosis
(most common cause globally)
|
Mitral
Stenosis
|
Pulmonary
embolism
|
Systemic
Coagulopathy
|
Acute/ Chronic Bhronicitis
|
Pneumonia
|
Left Heart failure
|
Raised pulmonary venous pressure (Mitral stenosis)
|
Anticoagulant/ Antiplatelet therapy
|
Bronchoectasis
|
Lung Abscess
|
Pulmonary Endometriosis (Catamenial
Hemoptysis )
|
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Airway trauma
|
Wegener Granulomatosis
|
Endobronchial Biopsy (Iatrogenic)
|
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Foreign Body
|
Good Pasture syndrome
|
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Nasopharyngeal
bleeding
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Lung Contusion
|
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Inhalational Injury (Burn, Smoke, Toxin, Cocaine)
|
Bold are very important
causes and MUST say causes of hemoptysis.
Red one is the most important of all.
Red one is the most important of all.
What is the source of
hemoptysis?
Medium and large sized airway of Lungs in close proximity to
bronchial artery and vein.
Which pneumonia are
associated with hemoptysis?
Tuberculosis with cavitary lesions (Most common)
CAP with cavitary lesions (Staphylococcus aureus, Klebsiella
)
COPD patient (Streptococcus pneumonaie, H. Influenzae, Moraxella catarallis)
COPD patient (Streptococcus pneumonaie, H. Influenzae, Moraxella catarallis)
Which Carcinoma of
lungs are more likely to cause hemoptysis? Why?
Squamous cell carcinoma and small cell carcinoma
These are large Cancers arising from proximal airway and
centrally located and hence can produce hemoptysis.
Why there is
hemoptysis in Mitral stenosis/ Congestive Heart Failure?
Congestive heart failure with transmission of elevated left
arterial pressure, if severe enough can lead to rupture of small alveolar
capillary. Thus hemoptysis is rarely frank bright red, rather it is pink frothy sputum
or blood tinged secretions.
What is massive
hemoptysis?
Hemoptysis greater than 200-600 ml in 24 hours. It is a
medical emergency as patient can exsanguinate and drown on his own aspirate.
What is the source of
profuse hemoptysis?
Massive hemorrhage can occur if the source of the blood is
from the high pressure systemic circulation that is the BRONCHIAL ARTERY. But
the bleeding is not so massive if the source is low pressure pulmonary
circulation that is alveolar capillary bleeding.
Source: Harrison
 |
| Causes of Hemoptysis |
