Hemoptysis is the expectoration of blood from the respiratory tract. Massive hemoptysis is defined as expectorating more than 100-600 mL of blood over 24 hours. True hemoptysis presents as bright red blood with an alkaline pH, while blood from the gastrointestinal tract appears dark red with an acidic pH. Common causes of hemoptysis include bronchial disease, parenchymal lung disease, lung vascular disease, and cardiovascular or blood disorders. A thorough history and physical exam can help determine the underlying cause and severity.

1. HEMOPTYSIS
Sanjay Kumar S
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2. HEMOPTYSIS
Definition
Expectoration of blood from the respiratory tract, a
spectrum that varies from blood-streaking of sputum to
coughing up large amounts of pure blood.
Massive hemoptysis – Expectoration of >100-600 ml over a
24-h period.

3. Features to differentiate between true
hemoptysis and blood originating from
gastrointestinal tract
True hemoptysis - Colour : Bright red
pH : Alkaline
Blood originating from GIT - Colour : Dark red
pH :Acidic

4. Causes of hemoptysis
Bronchial disease
Carcinoma Bronchial oedema
Bronchiectasis Foreign body
Acute bronchitis
Parenchymal disease
Tuberculosis Trauma
Suppurative pneumonia Actinomycosis
Lung abscess Mycetoma
Parasites (eg. Hadatid disease,flukes)

5. Lung vascular disease
Pulmonary infarction Polyarteritis nodosa
Goodpasture’s syndrome Idiopathic pulmonary
haemosiderosis
Cardiovascular disease
Acute left ventricular failure Aortic aneurysm
Mitral stenosis
Blood disorders
Leukaemia Anticoagulants
Haemophilia

6. HISTORY
• Diff from haemetemesis & epistaxis
• Amount
• Previous episodes
• h/o inhalation exposure
• Smoking
• Fever
• Dyspnea
• Weight loss

7. • use of illicit substances/risks for
thromboembolism/ use of
antiplatelet,anticoagulants/FB/intubation
• Past h/o malignancy ,rheumatologic disease,
Vascular disease, underlying lung disease-like
bronchiectasis
• h/o renal insufficiency

8. Physical examination
• PICCLE-pallor ,clubbing
• Vitals Incl. JVP
• CVS & RS
• Mucocutaneous telengiectasia