|
|
| (42 intermediate revisions by 7 users not shown) |
| Line 1: |
Line 1: |
| __NOTOC__ | | __NOTOC__ |
| {{Infobox_Disease | | | {| class="infobox" style="float:right;" |
| Name = Hemoptysis |
| | |- |
| ICD10 = {{ICD10|R|04|2|r|00}} |
| | | [[File:Siren.gif|link=Hemoptysis resident survival guide|41x41px]] || <br> || <br> |
| ICD9 = {{ICD9|786.3}} |
| | | [[Hemoptysis resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] |
| ICDO = |
| | |} |
| Image = |
| | {{Hemoptysis}} |
| Caption = |
| |
| OMIM = |
| |
| OMIM_mult = |
| |
| MedlinePlus = 003073 |
| |
| eMedicineSubj = |
| |
| eMedicineTopic = |
| |
| DiseasesDB = 5578 |
| |
| }}
| |
| {{SI}} | |
| {{CMG}}
| |
|
| |
|
| {{SK}} Spitting up blood; bloody sputum; coughing up blood; blood in sputum
| | '''For hemoptysis resident survival guide, click [[Hemoptysis resident survival guide|here]].''' |
|
| |
|
| ==Overview==
| | '''For patient information, click [[{{PAGENAME}} (patient information)|here]].''' |
| '''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. | |
|
| |
|
| ==Pathophysiology==
| | {{CMG}}; {{AE}} {{SSH}} |
| In most cases of hemoptysis, bleeding comes from the bronchial arteries as opposed to the pulmonary arteries.
| |
|
| |
|
| ==Causes==
| | {{SK}} Spitting up blood; bloody sputum; coughing up blood; blood in sputum; haemoptysis |
| ===Common Causes===
| |
| Common causes of hemoptysis include:
| |
| * [[Bronchitis]]
| |
| * [[Pneumonia]]
| |
| * [[Lung cancer|Lung neoplasm]] (in smokers, when hemoptysis is persistent)
| |
| * [[Aspergilloma]]
| |
| * [[Tuberculosis]]
| |
| * [[Bronchiectasis]]
| |
| * [[Coccidioidomycosis]]
| |
| * [[Pulmonary embolism]]
| |
| * [[Bubonic plague|Pneumonic plague]]
| |
|
| |
|
| | ==[[Hemoptysis overview|Overview]]== |
|
| |
|
| | ==[[Hemoptysis historical perspective|Historical Perspective]]== |
|
| |
|
| It can result from over-anticoagulation from treatment by drugs such as [[warfarin]].
| | == [[Hemoptysis classification|Classification]] == |
|
| |
|
| Cardiac causes like congestive heart failure and mitral stenosis should be ruled out.
| | ==[[Hemoptysis pathophysiology|Pathophysiology]]== |
| | ==[[Hemoptysis causes|Causes]]== |
|
| |
|
| 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]].
| | ==[[Hemoptysis differential diagnosis|Differentiating Hemoptysis from other Diseases]]== |
|
| |
|
| 20% of the cases of hemoptysis are idiopathic in nature.
| | ==[[Hemoptysis epidemiology and demographics|Epidemiology and Demographics]]== |
|
| |
|
| ===Causes in Alphabetical Order=== | | ==[[Hemoptysis risk factors|Risk Factors]]== |
| * [[Actinomycosis]]
| |
| * [[Adult Respiratory Distress Syndrome]] (ARDS)
| |
| * [[Amyloidosis]]
| |
| * [[Aortic Aneurysm]]
| |
| * [[Arteriovenous malformation]] ([[AVM]])
| |
| * [[Aspergilloma]]
| |
| * Aspiration (foreign body)
| |
| * [[Behcet's Syndrome]]
| |
| * [[Biopsy]]
| |
| * Bleeding gums
| |
| * Bronchial [[adenoma]]
| |
| * [[Bronchitis]]
| |
| * [[Bronchiectasis]]
| |
| * [[Bronchogenic carcinoma]]
| |
| * Broncholithiasis
| |
| * Bronchoscopy
| |
| * [[Coagulopathy]]
| |
| * [[Cocaine]] use
| |
| * [[Congestive Heart Failure]]
| |
| * [[Cystic Fibrosis]]
| |
| * [[Cytotoxic drug]] use
| |
| * [[Echinococcal cyst]]
| |
| * [[Endometriosis]]
| |
| * [[Esophageal tumors]]
| |
| * [[Fistula]] (between vasculature and airway)
| |
| * [[Goodpasture's Syndrome]]
| |
| * [[Heart failure]]
| |
| * Hemorrhagic diathesis
| |
| * [[Hereditary hemorrhagic telangiectasia]] (HHT or [[Rendu-Osler-Weber syndrome]])
| |
| * [[Henoch-Schonlein Purpura]]
| |
| * [[Histiocytosis X]]
| |
| * [[Idiopathic pulmonary hemosiderosis]]
| |
| * Intrathoracic [[endometriosis]]
| |
| * [[Laryngitis]]
| |
| * Laryngoscopy
| |
| * [[Lung abscess]]
| |
| * Lung contusion
| |
| * Malignant [[lymphoma]]
| |
| * [[Mediastinal tumors]]
| |
| * Mediastinoscopy
| |
| * [[Metastases]]
| |
| * [[Mitral Stenosis]]
| |
| * [[Nosebleed]]
| |
| * [[Oral Candidiasis]]
| |
| * [[Osler-Weber-Rendu Syndrome]]
| |
| * [[Pharyngitis]]
| |
| * [[Pneumonia]]
| |
| * [[Polyarteritis Nodosa]]
| |
| * [[Primary pulmonary hypertension]]
| |
| * Pulmonary arteriovenous fistula
| |
| * Pulmonary congestion
| |
| * [[Pulmonary Embolism]]
| |
| * [[Pulmonary fibrosis]]
| |
| * Pulmonary [[hemangioma]]
| |
| * Pulmonary [[hemosiderosis]]
| |
| * [[Pulmonary Infarction]]
| |
| * Ruptured [[aortic aneurysm]]
| |
| * Ruptured bronchi
| |
| * [[Sarcoidosis]]
| |
| * Septic [[pulmonary emboli]]
| |
| * Shrapnel
| |
| * Spirometry
| |
| * [[Systemic Lupus Erythematosus]]
| |
| * Tonsillectomy
| |
| * [[Tracheitis]]
| |
| * [[Trauma]]
| |
| * [[Tuberculosis]]
| |
| * Violent [[coughing]]
| |
| * [[Wegener's Granulomatosis]] <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
| |
|
| |
|
| ==Natural Hisotry, Compilcations and Prognosis== | | ==[[Hemoptysis screening|Screening]]== |
| Although uncommon, massive hemoptysis may be fatal.
| |
|
| |
|
| ==Diagnostic== | | ==[[Hemoptysis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| [[Image:hemoptysis.png]] | |
| == Laboratory Findings ==
| |
| * [[Complete blood count]] ([[CBC]])
| |
| * [[Sputum]] for acid-fast stain
| |
| * [[Cytology]]
| |
| * [[Gram stain]] / culture
| |
| * [[Prothrombin time]]/[[partial thromboplastin time]] ([[PT]] / [[PTT]])
| |
| * [[Pulse oximetry]]
| |
| * [[Urinalysis]]
| |
| * [[Blood urea nitrogen]] ([[BUN]])/[[creatinine]])
| |
| * Possible immunologic tests
| |
| * [[Arterial blood gases]]
| |
|
| |
|
| ==== Electrolyte and Biomarker Studies ==== | | ==Diagnosis== |
| * [[Electrolytes]]
| | [[Hemoptysis diagnostic study of choice|Diagnostic Study of Choice]] | [[Hemoptysis history and symptoms|History and Symptoms]] | [[ Hemoptysis physical examination|Physical Examination]] | [[Hemoptysis laboratory findings|Laboratory Findings]] | [[Hemoptysis electrocardiogram|Electrocardiogram]] | [[Hemoptysis x ray|X-Ray Findings]] | [[Hemoptysis echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Hemoptysis CT scan|CT-Scan Findings]] | [[Hemoptysis MRI|MRI Findings]] | [[Hemoptysis other imaging findings|Other Imaging Findings]] | [[Hemoptysis other diagnostic studies|Other Diagnostic Studies]] |
| ==== Chest X Ray ====
| |
| * [[Chest X-ray]] for both major and minor [[hemoptysis]]
| |
| ==== CT ====
| |
| * Chest [[CT scan]] to show focal bleeding
| |
| === Other Diagnostic Studies ===
| |
| * [[Bronchoscopy]]
| |
|
| |
|
| == Treatment == | | ==Treatment== |
| * Treat underling etiologies for minor hemoptysis
| | [[Hemoptysis medical therapy|Medical Therapy]] | [[Hemoptysis surgery |Surgery]] | [[Hemoptysis primary prevention|Primary Prevention]] | [[Hemoptysis secondary prevention|Secondary Prevention]] | [[Hemoptysis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Hemoptysis future or investigational therapies|Future or Investigational Therapies]] |
| * Special attention to '''airway, breathing''' and '''circulation'''
| |
| * Administration of supplemental O2
| |
| * Stablize hemodynamics
| |
| * Cough suppression
| |
| * Intubation
| |
|
| |
|
| === Acute Pharmacotherapies === | | ==Case Studies== |
| * IV [[estrogen]]
| |
|
| |
|
| === Surgery and Device Based Therapy ===
| | [[Hemoptysis case study one|Case #1]] |
| * Bronchoscopic balloon tamponade
| |
| * Arteriography and embolization
| |
| * Emergent thoracic surgery
| |
|
| |
|
| ==External links==
| | [[Category:Medicine]] |
| | | [[Category:Gastroenterology]] |
| * [http://www.virtualcancercentre.com/symptoms.asp?sid=58 Haemoptysis] Virtual Cancer Centre
| | [[Category:Up-To-Date]] |
| | | [[Category:Emergency medicine]] |
| ==References==
| |
| {{Reflist|2}}
| |
| | |
| {{Symptoms and signs}}
| |
| | |
| | |
| {{WH}}
| |
| {{WS}}
| |
| | |
| [[Category:Pulmonology]] | |
| [[Category:Signs and symptoms]] | |
