Hemoptysis natural history, complications and prognosis: Difference between revisions
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Latest revision as of 22:03, 29 July 2020
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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.