Haemoptysis ( coughing up blood )

Haemoptysis is expectoration of blood from the lower respiratory tract below the glottis.

In primary care the common causes of haemoptysis are acute and chronic bronchiectasis , TB , lung cancer , pneumonia and bronchiectasis ( BMJ best practice )

Infections - common cause in up to 60-70 % cases Pulmonary tuberculosis Pneumonia Bronchiectasis Chronic bronchitis Periodontal disease Sinusitis Tracheitis Lung abscess Fungal infections HIV.

Neoplasm -Lung cancer Lung metastasis Endobronchial tumours.

Vascular - AV malformations Arterio-bronchial fistula Ruptured thoracic aneurysm.

Autoimmune - Systemic lupus erythematosus Goodpasture syndrome Wegener's granulomatosis.

Cardiovascular - Pulmonary hypertension Pulmonary embolus LVF Severe mitral stenosis.

Trauma - complications of procedures as transbronchial lung biopsy , FNAC Lung contusion , penetrating injury Oral trauma epistaxis.

Children - lower resp tr infections bronchiectasis ( particularly in cystic fibrosis ) foreign body aspiration congenital cardiopathy.

Drugs - crack cocaine anticoagulants / antiplatelet

Haematological - coagulopathies thrombocytopenia plateket dysfunction

Iatrogenic/ Idiopathic or cryptogenic diagnosis of exclusion can be seen in 7 % to 34 % of cases.

Terminology - From Greek - spitting blood ( haima is blood and ptysis is spitting )

Pseudohaemoptysis - expectorated blood that does not arise from the lungs or the bronchial tubes blood...