Hemoptysis

Hematemesis

History

Absence of nausea/vomiting

Nausea/vomiting

Associated hypoxia

Hypoxia less common

Lung disease

Gastrointestinal and/or hepatic disease

Sputum appearance

Frothy or clotted

Coffee ground

Bright red or pink

Dark red, brown, or black

Laboratory studies

Alkaline pH (>7)

Acidic pH (<7)

Additional pertinent historical features include:

Amount of blood expectorated [6]
- Mild hemoptysis: less than 30 mL in 24 h
- Moderate hemoptysis: between 30 and 200 mL in 24 h
- Massive hemoptysis: greater than 200 mL in 24 h
Prior episodes of hemoptysis
- Known parenchymal disease such as chronic obstructive pulmonary disease, recurrent pneumonia, and bronchiectasis
Symptoms suggestive of infection (fever, chills, night sweats)
- Pneumonia, bronchitis, upper respiratory tract infection, and sinusitis
Weight loss
- HIV, tuberculosis, malignancy, and bronchiectasis
Tobacco use
- Primary lung malignancy
Dyspnea on exertion, orthopnea, and paroxysmal nocturnal dyspnea
- Congestive heart failure and mitral valve stenosis
Pleuritic chest pain or recent immobilization
- Pulmonary embolism or infarction
Vomiting, melena, alcohol abuse, and chronic or excessive NSAID use
- Gastric ulcer, gastric varices, and Mallory-Weiss tear
Hematuria
- Goodpasture syndrome
Hemoptysis associated with menses
- Pulmonary endometriosis
Travel history
- Tuberculosis, fungal, or parasitic infections
Anticoagulant use
Recent percutaneous or transbronchial procedures

13.6 Physical Examination

The physical examination may provide insight on the cause and location of the bleeding

Nov 20, 2017 | Posted by admin in Uncategorized | Comments Off