Medical symptom consisting of bloody mucus from coughing
Medical condition
Hemoptysis or haemoptysis is the discharge of blood or blood-stained mucus through the mouth coming from the bronchi, larynx, trachea, or lungs. It does not necessarily involve coughing. In other words, it is the airway bleeding. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, and certain cardiovascular conditions. Hemoptysis is considered massive at 300 mL (11 imp fl oz; 10 US fl oz). In such cases, there are always severe injuries. The primary danger comes from choking, rather than blood loss.[1]
Diagnosis
Past history, history of present illness, family history[2]
history of tuberculosis, bronchiectasis, chronic bronchitis, mitral stenosis, etc.
history of cigarette smoking, occupational diseases by exposure to silica dust, etc.
Blood
duration, frequency, amount
Amounts of blood: large amounts of blood, or is there blood-streaked sputum
Probable source of bleeding: Is the blood coughed up, or vomited?
Blood-laced mucus from the sinus or nose area can sometimes be misidentified as symptomatic of hemoptysis (such secretions can be a sign of nasal or sinus cancer, but also a sinus infection). Extensive non-respiratory injury can also cause one to cough up blood. Cardiac causes like congestive heart failure and mitral stenosis should be ruled out. The origin of blood can be identified by observing its color. Bright-red, foamy blood comes from the respiratory tract, whereas dark-red, coffee-colored blood comes from the gastrointestinal tract. Sometimes hemoptysis may be rust-colored.[citation needed]
Lung cancer, including both non-small cell lung carcinoma and small cell lung carcinoma.[5][6]
Although there are reports that the fatality rate is as high as 80%, the mortality rate for hospitalized hemoptysis patients is 9.4% (with n=28539), calculated from the data in the article by Kinoshita et al.[27] This is probably the most reasonable figure considering the overwhelming number of cases.[citation needed]
The general definition of massive hemoptysis is more than 200 ml within 24 hours, but there is a wide range in the literature (100-600 ml). Considering that the total volume of the tracheal and bronchial lumen is about 150 cc,[28][29] it may be reasonable to define massive hemoptysis as 200 ml, which is a little more than 150 ml, in terms of setting the threshold for fatal hemoptysis. More than 400ml/day is not adequate for screening purposes.[citation needed]
^"Granulomatosis with Polyangiitis". www.mayoclinic.org. Mayo Foundation for Medical Education and Research. Archived from the original on 22 December 2017. Retrieved 3 March 2018.
^Adu, Emery & Madaio 2012, p. 125.
^Villa-Forte, Alexandra. "Eosinophilic Granulomatosis with Polyangiitis (EGPA)". www.msdmanuals.com. Merck & Co. Retrieved 7 September 2024.
^ a b"Hemoptysis Causes – Hemoptysis – HealthCommunities.com". Archived from the original on 2009-01-23. Retrieved 2010-02-05.
^ a b c d"Other Causes of Hemoptysis – Hemoptysis – HealthCommunities.com". Archived from the original on 2009-06-08. Retrieved 2010-02-05.
^"Mitral Stenosis". The Lecturio Medical Concept Library. Retrieved 24 July 2021.
^Hunt, Beverley J. (2014). "Bleeding and Coagulopathies in Critical Care". New England Journal of Medicine. 370 (9): 847–859. doi:10.1056/NEJMra1208626. ISSN 0028-4793. PMID 24571757.
^Hughes, JP; Stovin, PG (January 1959). "Segmental pulmonary artery aneurysms with peripheral venous thrombosis". British Journal of Diseases of the Chest. 53 (1): 19–27. doi:10.1016/S0007-0971(59)80106-6. PMID 13618502.
^ a bKinoshita T, Ohbe H, Matsui H, Fushimi K, Ogura H, Yasunaga H (November 2019). "Effect of tranexamic acid on mortality in patients with haemoptysis: a nationwide study". Critical Care. 23 (1): 347. doi:10.1186/s13054-019-2620-5. PMC 6836388. PMID 31694697.
^Patwa A, Shah A (September 2015). "Anatomy and physiology of respiratory system relevant to anaesthesia". Indian Journal of Anaesthesia. 59 (9): 533–41. doi:10.4103/0019-5049.165849. PMC 4613399. PMID 26556911.
^Valipour A, Kreuzer A, Koller H, Koessler W, Burghuber OC (June 2005). "Bronchoscopy-guided topical hemostatic tamponade therapy for the management of life-threatening hemoptysis". Chest. 127 (6): 2113–8. doi:10.1378/chest.127.6.2113. PMID 15947328.
^Hanson C, Karlsson CA, Kämpe M, Lamberg K, Lindberg E, Boman LM, Stålenheim G (August 2004). Guidelines for treatment of acute lung diseases (Report). Uppsala Academic Hospital.
^Woo S, Yoon CJ, Chung JW, Kang SG, Jae HJ, Kim HC, et al. (November 2013). "Bronchial artery embolization to control hemoptysis: comparison of N-butyl-2-cyanoacrylate and polyvinyl alcohol particles". Radiology. 269 (2): 594–602. doi:10.1148/radiol.13130046. PMID 23801773. S2CID 21597160.
^Ishikawa H, Hara M, Ryuge M, Takafuji J, Youmoto M, Akira M, et al. (February 2017). "Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study". BMJ Open. 7 (2): e014805. doi:10.1136/bmjopen-2016-014805. PMC 5318547. PMID 28213604.
^Ryuge M, Hara M, Hiroe T, Omachi N, Minomo S, Kitaguchi K, et al. (February 2019). "Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study". European Radiology. 29 (2): 707–715. doi:10.1007/s00330-018-5637-2. PMC 6302874. PMID 30054792.
^Panda A, Bhalla AS, Goyal A (2017-07-07). "Bronchial artery embolization in hemoptysis: a systematic review". Diagnostic and Interventional Radiology. 23 (4): 307–317. doi:10.5152/dir.2017.16454. PMC 5508955. PMID 28703105.
^Olsen KM, Manouchehr-Pour S, Donnelly EF, Henry TS, Berry MF, Boiselle PM, et al. (May 2020). "ACR Appropriateness Criteria® Hemoptysis". Journal of the American College of Radiology. 17 (5S): S148–S159. doi:10.1016/j.jacr.2020.01.043. PMID 32370959. S2CID 218520816.
Further reading
Adu D, Emery P, Madaio M (2012). Rheumatology and the Kidney (2, illustrated ed.). Oxford University Press. ISBN 9780199579655.
Corey R (1990). "Chapter 39: Hemoptysis". In Walker HK, Hall WD, Hurst JW (eds.). Clinical Methods: The History, Physical, and Laboratory Examinations. Boston: Butterworths. ISBN 978-0-409-90077-4. PMID 21250201.