Haemoptysis Flashcards
What blood vessels are most significantly implicated in haemoptysis?
Bronchial arteries
They contain a small proportion of the cardiac output but they have a high pressure
Define haemoptysis.
Coughing up blood or bloody sputum from respiratory tract below larynx
Give examples of causes of haemoptysis in the airways, parenchyma and pulmonary vasculature.
Airways: cancer, bronchiectasis, bronchitis, sarcoidosis
Parenchyma: infection (TB, aspergilloma), inflammation
Pulmonary vasculature: Thromboembolism, pulmonary infarction
What are the standard investigations given to someone with haemoptysis?
CXR
FBC
ABG
Sputum may be useful
What does a cavitating lesion combined with coughing up blood suggest?
TB
What does cardiomegaly combined with peri-hilar consolidation suggest?
Heart failure
What do signet rings on a CT scan suggest?
Bronchiectasis - bronchial walls thickened and dilated
What are the commonest causes of haemoptysis manifesting as streaks/small clots?
Bronchiectasis, Lung Cancer, TB
Smokers, HF, PE, anticoagulants
What are the commonest causes of massive haemoptysis?
Bronchiectasis, Lung Cancer, TB
Aspergilloma, Vascular abnormalities
What is the management of massive haemoptysis?
Manage patient bleeding side down, so it does not go into other lung
Maintain systolic BP < 100
Tranexamic acid
Nebulised adrenaline
What does production of an eggcup full of yellow green sputum everyday suggest?
Chronic Bronchial Sepsis
But also Bronchiectasis!
What does a cavitating mass in the upper lobe with air inside suggest?
Aspergilloma
Define bronchiectasis.
Abnormal and permanent/chronic dilation of one or more bronchi
What are inherited causes for bronchiectasis? (2 marks)
CF, immotile cilia syndromes
What are the physical signs of bronchiectasis? (5 marks)
Breathlessness Polyphonic wheeze Finger clubbing Coarse mid-inspiratory crackles Respiratory failure
