Hemoptysis
Hematemesis
History
History
Absence of nausea/vomiting
Nausea/vomiting
Associated hypoxia
Hypoxia less common
Lung disease
Gastrointestinal and/or hepatic disease
Sputum appearance
Sputum appearance
Frothy or clotted
Coffee ground
Bright red or pink
Dark red, brown, or black
Laboratory studies
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
Vital signs
Fever, hypo-/hyperthermia, and elevated respiratory rate should alert the physician to possible infectious etiology.Related posts:
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