Investigation of hemoptysis (summary)

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This is a basic article for medical students and other non-radiologists.

Haemoptysis is the coughing up of frank blood or blood-stained mucus/pus from the lungs and it is an important indicator of pathology. Careful assessment of history, clinical examination and investigations will help elicit the source of haemoptysis.

Reference article

This is a summary article; read more in our article on haemoptysis.

Summary

history
- differentiate between haemoptysis, pseudohaemoptysis and haematemesis
  - haemoptysis - typically bright red, frothy sputum
    - volume, frequency, fresh/altered blood
  - pseudohaemoptysis - source other than lower respiratory tract
    - e.g. upper airway bleed initiates cough reflex
- investigate for other symptoms of pathology
  - respiratory - cough, sputum, wheeze, shortness of breath
  - constitutional - fever, weight loss, fatigue, night sweats
aetiology (with typical associations)
- lung cancer
  - smoking Hxhistory, older age, symptoms of malignancy
- tuberculosis
  - immunocompromised patients, constitutional symptoms
- bronchiectasis
  - chronic productive cough
- pneumonia
  - acute productive cough/sputum (n.b. rust-coloured sputum pneumococcal bacteria)
- pulmonary embolism
  - pleuritic chest pain, ~~DVT Hx~~deep vein thrombosis history
- bronchitis
  - occasionally mild haemoptysis
- pulmonary oedema
  - pink frothy sputum, dyspnea, fine crackles at lung bases
- Goodpasture's syndrome
  - glomerulonephritis, systemically unwell
- granulomatosis with polyangiitis
  - epistaxis, arthritis, glomerulonephritis
investigations
- : haemoptysis always requires investigation

-<h6>This is a basic article for medical students and other non-radiologists.</h6><p><strong>Haemoptysis </strong>is the coughing up of blood or blood-stained mucus from the lungs and it is an important indicator of pathology. Careful assessment of history, clinical examination and investigations will help elicit the source of haemoptysis.</p><h4>Reference article</h4><p>This is a <a href="/articles/summary-article">summary article</a>; read more in our article on <a href="/articles/haemoptysis-1">haemoptysis</a>.</p><h4>Summary</h4><ul>
+<h6>This is a basic article for medical students and other non-radiologists.</h6><p><strong>Haemoptysis </strong>is the coughing up of frank blood or blood-stained mucus/pus from the lungs and it is an important indicator of pathology. Careful assessment of history, clinical examination and investigations will help elicit the source of haemoptysis.</p><h4>Reference article</h4><p>This is a <a href="/articles/summary-article">summary article</a>; read more in our article on <a href="/articles/haemoptysis-1">haemoptysis</a>.</p><h4>Summary</h4><ul>
~~-<a href="/articles/lung-cancer-3">lung cancer</a><ul><li>smoking Hx, older age, symptoms of malignancy</li></ul>~~
+<a href="/articles/lung-cancer-3">lung cancer</a><ul><li>smoking history, older age, symptoms of malignancy</li></ul>
~~-<a href="/articles/pulmonary-embolism">pulmonary embolism</a><ul><li>pleuritic chest pain, DVT Hx</li></ul>~~
+<a href="/articles/pulmonary-embolism">pulmonary embolism</a><ul><li>pleuritic chest pain, <a title="Deep vein thrombosis" href="/articles/deep-vein-thrombosis">deep vein thrombosis</a> history</li></ul>
~~-<a href="/articles/goodpasture-syndrome">Goodpasture's syndrome</a><ul><li>glomerulonephritis, systemically unwell</li></ul>~~
+<a href="/articles/goodpasture-syndrome">Goodpasture syndrome</a><ul><li>glomerulonephritis, systemically unwell</li></ul>
~~-<strong>investigations</strong><ul>~~
~~-<li>haemoptysis always requires investigation</li>~~
~~-<li>chest x-ray</li>~~
~~-<li>CT scan</li>~~
~~-<li>pulmonary angiography</li>~~
~~-<li>V/Q scan</li>~~
+<strong>investigations</strong>: haemoptysis always requires investigation<ul>
+<li><a title="Chest x-ray" href="/articles/chest-radiograph">chest x-ray</a></li>
+<li>CT chest</li>
+<li><a title="V/Q scan" href="/articles/vq-scan-2">V/Q scan</a></li>
+<li>pulmonary angiography (rarely performed nowadays)</li>