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__NOTOC__ | __NOTOC__ | ||
{{Hemoptysis}} | |||
{{CMG}}; {{AE}} {{SSH}} | |||
==Overview== | ==Overview== | ||
==Natural | Hemoptysis is an important [[symptom]] that indicates an underlying [[Lung|pulmonary]] or extrapulmonary causes. Hemoptysis usually happens following [[bronchitis]] as an acute [[symptom]] and it resolves spontaneously or with [[antibiotic]] therapy within a week. Watchful observation in a patient with hemoptysis and normal [[Chest X-ray|chest x-ray]] is recommended. However, persistent and massive hemoptysis requires further investigations. [[Asphyxia]] and [[airway obstruction]] are common after massive hemoptysis. [[Prognosis]] of hemoptysis is generally excellent. However, massive hemoptysis has a poor [[prognosis]] and the [[mortality rate]] of patients with hemoptysis is approximately 50-100%, if left untreated. | ||
==Natural History, Complications, and Prognosis== | |||
===Natural History=== | |||
*Hemoptysis is an important [[symptom]] that indicates an underlying [[Lung|pulmonary]] or extrapulmonary causes.<ref>Corey R. Hemoptysis. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 39. Available from: https://www.ncbi.nlm.nih.gov/books/NBK360/</ref><ref name="LeeLee2012">{{cite journal|last1=Lee|first1=Yeon Joo|last2=Lee|first2=Sang-Min|last3=Park|first3=Jong Sun|last4=Yim|first4=Jae-Joon|last5=Yang|first5=Seok-Chul|last6=Kim|first6=Young Whan|last7=Han|first7=Sung Koo|last8=Lee|first8=Jae Ho|last9=Lee|first9=Choon-Taek|last10=Yoon|first10=Ho Il|last11=Yoo|first11=Chul-Gyu|title=The clinical implications of bronchoscopy in hemoptysis patients with no explainable lesions in computed tomography|journal=Respiratory Medicine|volume=106|issue=3|year=2012|pages=413–419|issn=09546111|doi=10.1016/j.rmed.2011.11.010}}</ref> | |||
*Hemoptysis usually happens following [[bronchitis]] as an acute [[symptom]] and it resolves spontaneously or with [[antibiotic]] therapy within a week.<ref name="LeeKim2015">{{cite journal|last1=Lee|first1=Myoung Kyu|last2=Kim|first2=Sang-Ha|last3=Yong|first3=Suk Joong|last4=Shin|first4=Kye Chul|last5=Kim|first5=Hyun Sik|last6=Yu|first6=Tae-Sun|last7=Choi|first7=Eun Hee|last8=Lee|first8=Won-Yeon|title=Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization|journal=The Clinical Respiratory Journal|volume=9|issue=1|year=2015|pages=53–64|issn=17526981|doi=10.1111/crj.12104}}</ref> | |||
*Watchful observation in a patient with hemoptysis and normal [[Chest X-ray|chest x-ray]] is recommended. | |||
*Patients with warning signs must be investigated. Warning signs are as follow:<ref name="KhalilFedida2015">{{cite journal|last1=Khalil|first1=A.|last2=Fedida|first2=B.|last3=Parrot|first3=A.|last4=Haddad|first4=S.|last5=Fartoukh|first5=M.|last6=Carette|first6=M.-F.|title=Severe hemoptysis: From diagnosis to embolization|journal=Diagnostic and Interventional Imaging|volume=96|issue=7-8|year=2015|pages=775–788|issn=22115684|doi=10.1016/j.diii.2015.06.007}}</ref><ref name="JonesLatinovic2007">{{cite journal|last1=Jones|first1=Roger|last2=Latinovic|first2=Radoslav|last3=Charlton|first3=Judith|last4=Gulliford|first4=Martin C|title=Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database|journal=BMJ|volume=334|issue=7602|year=2007|pages=1040|issn=0959-8138|doi=10.1136/bmj.39171.637106.AE}}</ref> | |||
** Persistent hemoptysis more than one week | |||
** [[Chest pain]] | |||
** [[Weight loss]] | |||
** [[Sleep hyperhidrosis|Night sweats]] | |||
** [[Fever]] higher than 101 degrees | |||
** [[Dyspnea|Shortness of breath]] | |||
** Change in [[cough]] | |||
** [[Fatigue]] | |||
===Complications=== | |||
*Common complications of massive hemoptysis include:<ref name="pmid10205720">{{cite journal |vauthors=Dweik RA, Stoller JK |title=Role of bronchoscopy in massive hemoptysis |journal=Clin. Chest Med. |volume=20 |issue=1 |pages=89–105 |year=1999 |pmid=10205720 |doi= |url=}}</ref><ref name="pmid15731957">{{cite journal |vauthors=Allewelt M, Lode H |title=[Diagnosis of haemoptoe/haemoptysis] |language=German |journal=Dtsch. Med. Wochenschr. |volume=130 |issue=9 |pages=450–2 |year=2005 |pmid=15731957 |doi=10.1055/s-2005-863074 |url=}}</ref> | |||
**[[Dehydration]] | |||
**[[Asphyxia]] | |||
**[[Airway obstruction]] | |||
**[[Shock]] | |||
**[[Exsanguination]] | |||
* Complications after bronchial artery [[Therapeutic embolization|embolization]] include:<ref name="Andersen2016">{{cite journal|last1=Andersen|first1=P. E.|title=Imaging and interventional radiological treatment of hemoptysis|journal=Acta Radiologica|volume=47|issue=8|year=2016|pages=780–792|issn=0284-1851|doi=10.1080/02841850600827577}}</ref><ref name="GuptaSrivastava2013">{{cite journal|last1=Gupta|first1=Mudit|last2=Srivastava|first2=Deep Narayan|last3=Seith|first3=Ashu|last4=Sharma|first4=Sanjay|last5=Thulkar|first5=Sanjay|last6=Gupta|first6=Rashmi|title=Clinical Impact of Multidetector Row Computed Tomography Before Bronchial Artery Embolization in Patients With Hemoptysis: A Prospective Study|journal=Canadian Association of Radiologists Journal|volume=64|issue=1|year=2013|pages=61–73|issn=08465371|doi=10.1016/j.carj.2011.08.002}}</ref><ref name="Kalva2009">{{cite journal|last1=Kalva|first1=Sanjeeva P.|title=Bronchial Artery Embolization|journal=Techniques in Vascular and Interventional Radiology|volume=12|issue=2|year=2009|pages=130–138|issn=10892516|doi=10.1053/j.tvir.2009.08.006}}</ref> | |||
** [[Spinal cord injury]] | |||
** [[Peptic ulcer|Esophageal ulcer]] | |||
** [[Stroke]] | |||
** Bronchial [[infarction]] | |||
** Transient [[chest pain]] | |||
===Prognosis=== | |||
*[[Prognosis]] of hemoptysis is generally excellent. However, it requires further investigations.<ref name="LeeKim2015">{{cite journal|last1=Lee|first1=Myoung Kyu|last2=Kim|first2=Sang-Ha|last3=Yong|first3=Suk Joong|last4=Shin|first4=Kye Chul|last5=Kim|first5=Hyun Sik|last6=Yu|first6=Tae-Sun|last7=Choi|first7=Eun Hee|last8=Lee|first8=Won-Yeon|title=Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization|journal=The Clinical Respiratory Journal|volume=9|issue=1|year=2015|pages=53–64|issn=17526981|doi=10.1111/crj.12104}}</ref> | |||
*Massive hemoptysis has a poor [[prognosis]] and the [[mortality rate]] of patients with hemoptysis is approximately 50-100%, if left untreated.<ref name="ShigemuraWan2009">{{cite journal|last1=Shigemura|first1=Norihisa|last2=Wan|first2=Innes Y.|last3=Yu|first3=Simon C.H.|last4=Wong|first4=Randolph H.|last5=Hsin|first5=Michael K.Y.|last6=Thung|first6=Hoi K.|last7=Lee|first7=Tak-Wai|last8=Wan|first8=Song|last9=Underwood|first9=Malcolm J.|last10=Yim|first10=Anthony P.C.|title=Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience|journal=The Annals of Thoracic Surgery|volume=87|issue=3|year=2009|pages=849–853|issn=00034975|doi=10.1016/j.athoracsur.2008.11.010}}</ref><ref name="NoëJaffé2011">{{cite journal|last1=Noë|first1=G.D.|last2=Jaffé|first2=S.M.|last3=Molan|first3=M.P.|title=CT and CT angiography in massive haemoptysis with emphasis on pre-embolization assessment|journal=Clinical Radiology|volume=66|issue=9|year=2011|pages=869–875|issn=00099260|doi=10.1016/j.crad.2011.03.001}}</ref> | |||
==References== | ==References== | ||
{{ | {{Reflist|2}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Overview
Hemoptysis is an important symptom that indicates an underlying pulmonary or extrapulmonary causes. Hemoptysis usually happens following bronchitis as an acute symptom and it resolves spontaneously or with antibiotic therapy within a week. Watchful observation in a patient with hemoptysis and normal chest x-ray is recommended. However, persistent and massive hemoptysis requires further investigations. Asphyxia and airway obstruction are common after massive hemoptysis. Prognosis of hemoptysis is generally excellent. However, massive hemoptysis has a poor prognosis and the mortality rate of patients with hemoptysis is approximately 50-100%, if left untreated.
Natural History, Complications, and Prognosis
Natural History
- Hemoptysis is an important symptom that indicates an underlying pulmonary or extrapulmonary causes.[1][2]
- Hemoptysis usually happens following bronchitis as an acute symptom and it resolves spontaneously or with antibiotic therapy within a week.[3]
- Watchful observation in a patient with hemoptysis and normal chest x-ray is recommended.
- Patients with warning signs must be investigated. Warning signs are as follow:[4][5]
- Persistent hemoptysis more than one week
- Chest pain
- Weight loss
- Night sweats
- Fever higher than 101 degrees
- Shortness of breath
- Change in cough
- Fatigue
Complications
- Common complications of massive hemoptysis include:[6][7]
- Complications after bronchial artery embolization include:[8][9][10]
- Spinal cord injury
- Esophageal ulcer
- Stroke
- Bronchial infarction
- Transient chest pain
Prognosis
- Prognosis of hemoptysis is generally excellent. However, it requires further investigations.[3]
- Massive hemoptysis has a poor prognosis and the mortality rate of patients with hemoptysis is approximately 50-100%, if left untreated.[11][12]
References
- ↑ Corey R. Hemoptysis. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 39. Available from: https://www.ncbi.nlm.nih.gov/books/NBK360/
- ↑ Lee, Yeon Joo; Lee, Sang-Min; Park, Jong Sun; Yim, Jae-Joon; Yang, Seok-Chul; Kim, Young Whan; Han, Sung Koo; Lee, Jae Ho; Lee, Choon-Taek; Yoon, Ho Il; Yoo, Chul-Gyu (2012). "The clinical implications of bronchoscopy in hemoptysis patients with no explainable lesions in computed tomography". Respiratory Medicine. 106 (3): 413–419. doi:10.1016/j.rmed.2011.11.010. ISSN 0954-6111.
- ↑ 3.0 3.1 Lee, Myoung Kyu; Kim, Sang-Ha; Yong, Suk Joong; Shin, Kye Chul; Kim, Hyun Sik; Yu, Tae-Sun; Choi, Eun Hee; Lee, Won-Yeon (2015). "Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization". The Clinical Respiratory Journal. 9 (1): 53–64. doi:10.1111/crj.12104. ISSN 1752-6981.
- ↑ Khalil, A.; Fedida, B.; Parrot, A.; Haddad, S.; Fartoukh, M.; Carette, M.-F. (2015). "Severe hemoptysis: From diagnosis to embolization". Diagnostic and Interventional Imaging. 96 (7–8): 775–788. doi:10.1016/j.diii.2015.06.007. ISSN 2211-5684.
- ↑ Jones, Roger; Latinovic, Radoslav; Charlton, Judith; Gulliford, Martin C (2007). "Alarm symptoms in early diagnosis of cancer in primary care: cohort study using General Practice Research Database". BMJ. 334 (7602): 1040. doi:10.1136/bmj.39171.637106.AE. ISSN 0959-8138.
- ↑ Dweik RA, Stoller JK (1999). "Role of bronchoscopy in massive hemoptysis". Clin. Chest Med. 20 (1): 89–105. PMID 10205720.
- ↑ Allewelt M, Lode H (2005). "[Diagnosis of haemoptoe/haemoptysis]". Dtsch. Med. Wochenschr. (in German). 130 (9): 450–2. doi:10.1055/s-2005-863074. PMID 15731957.
- ↑ Andersen, P. E. (2016). "Imaging and interventional radiological treatment of hemoptysis". Acta Radiologica. 47 (8): 780–792. doi:10.1080/02841850600827577. ISSN 0284-1851.
- ↑ Gupta, Mudit; Srivastava, Deep Narayan; Seith, Ashu; Sharma, Sanjay; Thulkar, Sanjay; Gupta, Rashmi (2013). "Clinical Impact of Multidetector Row Computed Tomography Before Bronchial Artery Embolization in Patients With Hemoptysis: A Prospective Study". Canadian Association of Radiologists Journal. 64 (1): 61–73. doi:10.1016/j.carj.2011.08.002. ISSN 0846-5371.
- ↑ Kalva, Sanjeeva P. (2009). "Bronchial Artery Embolization". Techniques in Vascular and Interventional Radiology. 12 (2): 130–138. doi:10.1053/j.tvir.2009.08.006. ISSN 1089-2516.
- ↑ Shigemura, Norihisa; Wan, Innes Y.; Yu, Simon C.H.; Wong, Randolph H.; Hsin, Michael K.Y.; Thung, Hoi K.; Lee, Tak-Wai; Wan, Song; Underwood, Malcolm J.; Yim, Anthony P.C. (2009). "Multidisciplinary Management of Life-Threatening Massive Hemoptysis: A 10-Year Experience". The Annals of Thoracic Surgery. 87 (3): 849–853. doi:10.1016/j.athoracsur.2008.11.010. ISSN 0003-4975.
- ↑ Noë, G.D.; Jaffé, S.M.; Molan, M.P. (2011). "CT and CT angiography in massive haemoptysis with emphasis on pre-embolization assessment". Clinical Radiology. 66 (9): 869–875. doi:10.1016/j.crad.2011.03.001. ISSN 0009-9260.