8.31 SFGH morning report pearls: massive hemoptysis

Definition: varies, often defined as >600 ml expectorated in 24 hours

  • leading cause worldwide: TB
  • leading cause in US: chronic inflammatory lung disease and bronchogenic carcinoma
  • majority originates from bronchial arteries (high systemic pressure), pulmonary arteries only the cause in ~5%.

Most common etiologies:

  • Neoplasm: bronchial carcinoma/adenoma and metastatic lung ca
  • Bronchiectasis
  • infections: mycobacteria, fungal, lung abscess, pargonimiasis, hydatid cyst
  • vascular: PE, mitral stenosis, iatrogenic damage to pulmonary artery, broncho-arterial fistula, AVM
  • Vasculitis: Behcet’s, GPA
  • miscellaneous: anticoagulant/coagulopathies, goodpasture’s

Jean-Baptiste, E.  Clinical assessment and management of massive hemoptysis.  Critical care Medicine.  28(5) 2000. 1642-1647.


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