Hemoptysis diagnostic study of choice
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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
Diagnostic Study of Choice
Study of choice
- The initial diagnostic study in a patient with hemoptysis is chest x-ray.[1]
- Chest x-ray might show underlying cause. However, it might be normal as well.[2]
- The next step is to perform high resolution CT scan or bronchoscopy.[3]
- HRCT is better in some conditions, such as:[4][5]
- Flexible bronchoscopy is better in some conditions, such as:[6]
- Subtle mucosal abnormalities
- Bronchitis
- Dieulafoy disease
- Kaposi sarcoma
- Subtle mucosal abnormalities
Diagnosis of Mild to Moderate Hemoptysis
The algorithm is based on the American Family Physician Journal of hemoptysis: Diagnosis and Management [7]
| Hemoptysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Mild hemoptysis ❑ <30 cc in 24 hours [8] | Moderate hemoptysis ❑ 30-200 cc in 24 hours [9] | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Chest X-ray (CXR) | Chest X-ray and CT | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Diagnose found | Diagnose unknown | Diagnose found | Diagnose unknown | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Treat underlying disease | Treat underlying disease | Bronchoscopy to find diagnosis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | Diagnose found | Diagnose unknown | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| CT or bronchoscopy to find diagnosis | Close monitoring | Treat underlying disease | Close monitoring | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Diagnose found | Diagnose unknown | If hemoptysis persist consult with pneumonologist | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Treat underlying Disease | Close monitoring | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ 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.
- ↑ Andersen, P. E. (2016). "Imaging and interventional radiological treatment of hemoptysis". Acta Radiologica. 47 (8): 780–792. doi:10.1080/02841850600827577. ISSN 0284-1851.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Sakr, L.; Dutau, H. (2010). "Massive Hemoptysis: An Update on the Role of Bronchoscopy in Diagnosis and Management". Respiration. 80 (1): 38–58. doi:10.1159/000274492. ISSN 1423-0356.
- ↑ name="pmid16225028">Bidwell JL, Pachner RW (2005). "Hemoptysis: diagnosis and management". Am Fam Physician. 72 (7): 1253–60. PMID 16225028.
- ↑ name="pmid12243312">Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B (2002). "Hemoptysis: a retrospective analysis of 108 cases". Respir Med. 96 (9): 677–80. PMID 12243312.
- ↑ name="pmid12243312">Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B (2002). "Hemoptysis: a retrospective analysis of 108 cases". Respir Med. 96 (9): 677–80. PMID 12243312.
- ↑ Parkin DM, Boyd L, Walker LC (2011). "16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010". Br J Cancer. 105 Suppl 2: S77–81. doi:10.1038/bjc.2011.489. PMC 3252065. PMID 22158327.