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 . In such cases, there are always severe injuries. The primary danger comes from choking, rather than blood loss.
Past history, history of present illness, family history
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?
Bloody sputum
color, characters: blood-streaked, fresh blood, frothy pink, bloody gelatinous.
Accompanying symptoms
fever, chest pain, coughing, purulent sputum, mucocutaneous bleeding, jaundice.
Imaging examination
chest X-ray, CT scan and 3D reconstruction images or CT virtual bronchoscopy, bronchial angiography.
Laboratory tests
blood test: WBC
Sputum: cells and bacterial examinations, sputum culture
Bronchial fiber endoscopy
The most common causes for hemoptysis in adults are chest infections such as bronchitis or pneumonia. In children, hemoptysis is commonly caused by the presence of a foreign body in the airway. Other common causes include lung cancers and tuberculosis. Less common causes include aspergilloma, bronchiectasis, coccidioidomycosis, pulmonary embolism, pneumonic plague, and cystic fibrosis. Rarer causes include hereditary hemorrhagic telangiectasia (HHT or Rendu-Osler-Weber syndrome), Goodpasture's syndrome, and granulomatosis with polyangiitis. A rare cause of hemoptysis in women is endometriosis, which leads to intermittent hemoptysis coinciding with menstrual periods in 7% of women with thoracic endometriosis syndrome.