Hemoptysis Flashcards
What conditions can mimic hemoptysis?
Hematemesis
What patient historical features can help distinguish hemoptysis from hematemesis?
Hematemesis: nausea, vomiting, Hx of gastric or hepatic disease, brown, black coffee ground looking blood.
Hemoptysis: absence of nausea and vomiting, preexisting lung disease, frothy bright red liquid or clotted appearing blood
What imaging should be ordered for hemoptysis? (2)
- Chest radiograph initially
2. CT w contrast is more sensitive
Which two body systems are involved in hemoptysis?
cardiovascular or pulmonary
What are the cardiovascular causes of hemoptysis? (4)
- Acute pulmonary arterial hypertension caused by PE and infarction
- Elevated left atrial pressure leading to rupture of alveolar capillaries caused by heart failure.
- Vasculitis
- Iatrogenic from bronchoscopy with bx
What are the pulmonary causes of heart failure?
- Pneumonia
- Lung abscess
- Tuberculosis
- Aspergillosis
- Staph, Klebsiella, pseudomonas infections.
What organisms are commonly associated with lung abscess?
Anaerobic organisms of the oral cavity including gram neg bacteroides and gram pos peptostreptococcus.
What are the 6 airway causes of hemoptysis?
- Acute bronchitis
- bronchiectasis
- Malignancy (weight loss, night sweats and hemoptysis)
- Foreign body aspiration
- Iatrogenic from endobronchial biopsy
- Bronchiovascular fistula
What is the threshold for life-threatening, emergent massive hemoptysis?
300 mL/d
