Content
The content of medical knowledge in this section of the site of the Lactology Foundation is intended for the practical needs of doctors, pharmacists and students in these specialties. It is more than reasonable to consult other authoritative medical sources before using our medical knowledge.
- Lung in Health and Disease
- General Approach to Patients
With Respiratory Disorders - Evaluating Lung Structure and Function
- Interstitial Lung Diseases
- Pulmonary Vascular Diseases
- Disorders of the Pleura,
Mediastinum, and Chest Wall - Respiratory Failure
- Lung Transplantation
- Perioperative Pulmonary Management
- COVID-19 Pulmonary Management
- Congenital Lung Malformations
- Sleep-Related Disorders
Hemoptysis
The coughing up of blood is called hemoptysis. It can usually be distinguished from hematemesis without problems.
Clinical Findings
The coughing up of blood
is called
hemoptysis. It can usually be
distinguished from he-
mathematics without
problems. Blood originating from
the
bronchial tree is coughed up and is of light red
color.
If blood is vomited, it is a dark
color and often mixed
with partially digested
food (“coffee grounds vomit-
ing”).
A
distinction should be made between small
amounts of blood mixed with sputum (minor
hemopty-
sis) and frank blood (major
hemoptysis). Minor
hemoptysis is often due to
injured hemorrhagic mucous
membranes. In
patients with known bronchiectasis,
minor
hemoptysis is often self-limited and does not
need further work-up in any case.
However, if
a smoker experiences minor hemoptysis,
meticulous work-up is mandatory and bronchial
carcinoma noma is an assumed cause until proven
otherwise.
Major hemoptysis is caused by the
bursting of a
bronchial artery in the wall of
an old tuberculous
cavern, an aspergilloma,
or due to lung cancer. The
origin of the
bleeding needs to be localized immediately
ately, as it is important for further treatment
(i. e., surgi-
cal resection or embolization
of bronchial arteries). The
risk of a patient
dying from hemoptysis due to asphyxia
depends
on the severity of the bleeding. Major
hemoptysis consisting of small amounts of blood
may
be a harbinger of sudden life-threatening
hemorrhage.
Etiology. The following causes of
hemoptysis need to be considered:
➤ common
causes: bronchial carcinoma, bronchiectasis
sis, chronic bronchitis, tuberculosis,
aspergilloma,
lung abscess, pulmonary
embolism, mitral stenosis
➤ rare causes:
foreign body, aortic aneurysm, Wegener
granulomatosis, and other vasculitides involving
the
lung (alveolar hemorrhage), bronchial
cysts, atrio-
ventricular (AV) malformations,
pulmonary en-
dometriosis.
Diagnostic
Work-Up
Radiologic investigations,
particularly
larly spiral computed tomography
(CT) and broncho-
copy, are mandatory. These
methods provide com-
plementary information
and allow in most cases a diag-
nosis of the
underlying disease and a localization of the
source of bleeding. It is not uncommon in
smokers with
chronic bronchitis and a normal
CT scan to find only
remnants of blood and no
active bleeding source during
bronchoscopy.
In such cases no further work-up is man-
datory, since recurrent hemoptysis is rare.
Please see also our Toxilact data base which is in the following language versions:
Toxilact Deutsche Sprachversion
Toxilact Nederlandstalige versie
Toxilakt έκδοση στην ελληνική γλώσσα
Toxilact English language version
Toxilact magyar nyelvű változat
Toxilact versione in lingua italiana
Toxilact polska wersja językowa
Pulmonary symptoms, findings and investigations
Assessment of chronic cough
Expectoration
Hemoptysis
Pleural Effusion
Approach to wheezing in children
Polysomnography
Pulmonary Function Testing
Toxicological risk during lactation
Toxicological lactation category I - the drug and/or its metabolites are either not eliminated through breast milk or are not toxic to the newborn and cannot lead to the development of absolutely any toxic reactions and adverse consequences for his health in the near and long term. Breast-feeding does not need to be discontinued while taking a given drug that falls into this toxicological lactation category.
Toxicological lactation category II - the drug and its metabolites are also eliminated through breast milk, but the plasma:milk ratio is very low and/or the excreted amounts cannot generate toxic reactions in the newborn due to various reasons, including degradation of the drug in the acid pool of the stomach of the newborn. Breastfeeding does not need to be discontinued while taking this medicine.
Toxicological lactation category III - the drug and/or its metabolites generate in breast milk equal to plasma concentrations or higher, and therefore the possible development of toxic reactions in the newborn can be expected. Breastfeeding should be discontinued for the period corresponding to the complete elimination of the drug or its metabolites from the mother's plasma.
Toxicological lactation category IV - the drug and/or its metabolites generate a plasma:milk ratio of 1:1 or higher and/or have a highly toxic profile for both the mother and the newborn, therefore their administration is incompatible with breastfeeding and it should to stop completely, and not just for the period of taking the drug, or to look for a less toxic therapeutic alternative.