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__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          = |
  Caption        = |
  OMIM          = |
  OMIM_mult      = |
  MedlinePlus    = 003073 |
  DiseasesDB    = 5578 |
}}
{{Hemoptysis}}
{{Hemoptysis}}
{{CMG}}


{{SK}} Spitting up blood; bloody sputum; coughing up blood; blood in sputum; haemoptysis;
'''For hemoptysis resident survival guide, click [[Hemoptysis resident survival guide|here]].'''


==Overview==
'''For patient information, click [[{{PAGENAME}} (patient information)|here]].'''
'''Hemoptysis''' 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]]
* [[Idiopathic]] - in 20% cases


===Causes in Alphabetical Order===
==[[Hemoptysis overview|Overview]]==
* [[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
* [[Coccidioidomycosis]]
* [[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]]
* [[Warfarin]] - excess [[anticoagulation]]
* [[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 historical perspective|Historical Perspective]]==
Although uncommon, massive hemoptysis may be fatal.


==Diagnostic==
== [[Hemoptysis classification|Classification]] ==
[[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 ====
==[[Hemoptysis pathophysiology|Pathophysiology]]==
* [[Electrolytes]]
==[[Hemoptysis causes|Causes]]==
==== 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 ==
==[[Hemoptysis differential diagnosis|Differentiating Hemoptysis from other Diseases]]==
* Treat underling etiologies for minor hemoptysis
* Special attention to '''airway, breathing''' and '''circulation'''
* Administration of supplemental O2
* Stablize hemodynamics
* Cough suppression
* Intubation


=== Acute Pharmacotherapies ===
==[[Hemoptysis epidemiology and demographics|Epidemiology and Demographics]]==
* IV [[estrogen]]


=== Surgery and Device Based Therapy ===
==[[Hemoptysis risk factors|Risk Factors]]==
* Bronchoscopic balloon tamponade
* Arteriography and embolization
* Emergent thoracic surgery


==References==
==[[Hemoptysis screening|Screening]]==
{{Reflist|2}}


{{Symptoms and signs}}
==[[Hemoptysis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
[[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]]


{{WH}}
==Treatment==
{{WS}}
[[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]]


[[Category:Pulmonology]]
==Case Studies==
[[Category:Signs and symptoms]]
 
[[Hemoptysis case study one|Case #1]]
 
[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]

Latest revision as of 22:02, 29 July 2020
Resident
Survival
Guide

Hemoptysis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hemoptysis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hemoptysis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hemoptysis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hemoptysis

CDC on Hemoptysis

Hemoptysis in the news

Blogs on Hemoptysis

Directions to Hospitals Treating Hemoptysis

Risk calculators and risk factors for Hemoptysis

For hemoptysis resident survival guide, click here.

For patient information, click here.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Synonyms and keywords: Spitting up blood; bloody sputum; coughing up blood; blood in sputum; haemoptysis

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hemoptysis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram |  X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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