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Symptoms
 
 

Haemoptysis

 
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Overview

Haemoptysis is the coughing up of bloody or blood-tinged sputum. This may be due to disease of the airways, pulmonary parenchyma or pulmonary vasculature.

Aetiology

  • Causes of Haemoptysis

  • Tracheobronchial

  • Cancer
  • Acute bronchitis
  • Chronic bronchitis
  • Bronchiectasis
  • Foreign body aspiration
  • Parenchymal

  • Infection - pneumonia, lung abscess, tuberculosis
  • Inflammatory - Goodpasture’s, Wegener’s granulomatosis
  • Lung contusion
  • Vascular

  • Pulmonary embolism
  • Arteriovenous malformation
  • Not True Haemoptysis

  • Haematemesis (upper GI bleed)
  • Oral source of bleeding
  • Nasopharyngeal bleed

History of Presenting Complaint

  • Onset

  • Whether the sputum was red from the start or began with a cough with or without sputum production.
  • Sputum

    The colour, volume and consistency of the sputum.
  • Bright or dark red sputumHaemoptysis
  • Yellow / green sputum with red streaksSuggestive of infectious cause
  • Pink, frothy sputumCharacteristic of acute pulmonary oedema
  • Coffee groundsSuggestive of haematemesis
  • Associated Symptoms

    Whether the cough is associated with any other symptoms.
  • FeversSuggestive of upper / lower respiratory tract infection
  • Pleuritic chest painSuggestive of pneumonia or PE
  • Chest pain and shortness of breathConcerning for PE
  • Duration

  • Whether the has been coughing up blood for days, weeks, months or years.
  • Course

    The frequency & length of coughing episodes, and whether it varies throughout the day.
  • Worse in the morningCharacteristic of smoker’s cough (chronic bronchitis)
  • Exacerbating Factors

    Whether the cough is triggered by anything.
  • Exacerbated by environmental allergensSuggestive of asthma or chemical exposure
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