Emergency Medicine/Hemoptysis

Hemoptysis

Hemoptysis is coughing up blood from the respiratory tract. The blood can come from the nose, mouth, throat, the airway passages leading to the lungs, or the lungs. The word "hemoptysis" comes from the Greek "haima," meaning "blood," and "ptysis," which means "a spitting".

Causes

Hemoptysis can be caused by a range of disorders:

• Infections. These include pneumonia; tuberculosis; aspergillosis; and parasitic diseases, including ascariasis, amebiasis, and paragonimiasis.
• Tumors that erode blood vessel walls.
• Drug abuse. Cocaine can cause massive hemoptysis.
• Trauma. Chest injuries can cause bleeding into the lungs.
• Vascular disorders, including aneurysms, pulmonary embolism, and malformations of the blood vessels.
• Bronchitis. Its most common cause is long-term smoking.
• Foreign object(s) in the airway.
• Blood clotting disorders.
• Bleeding following such surgical procedures as bronchial biopsies and heart catheterization.

Treatment

• Massive hemoptysis is a life-threatening emergency that requires treatment in an intensive care unit. The patient will be intubated (the insertion of a tube to help breathing) to protect the airway, and to allow evaluation of the source of the bleeding.
• Patients with lung cancer, bleeding from an aneurysm (blood clot), or persistent traumatic bleeding require chest surgery.
• Patients with tuberculosis, aspergillosis, or bacterial pneumonia are given antibiotics.
• Foreign objects are removed with a bronchoscope.
• If the cause cannot be determined, the patient is monitored for further developments.