Medical history (history of illness) represents an important component in the diagnosis of hemoptysis (hemoptysis). Family history What is the general health of your relatives? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical history/systemic medical history (somatic … Coughing Up Blood (Hemoptysis): Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Pulmonary AV malformation – malformations in the vascular system of the lungs. Respiratory system (J00-J99 Bronchiectasis (synonym: bronchiectasis) – persistent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and … Coughing Up Blood (Hemoptysis): Or something else? Differential Diagnosis
The following symptoms and complaints may indicate hemoptysis (coughing up blood): Leading symptoms Bleeding from mouth/nose Light red/dark red/black color of the blood Warning signs (red flags) Anamnestic information: Immigrants, homeless, and elderly patients → think of: Tuberculosis Smokers → think of: Bronchial carcinoma (lung cancer) Any smoker with hemoptysis (about 30% of all cases … Coughing Up Blood (Hemoptysis): Symptoms, Complaints, Signs
General measures Monitor or ensure vital signs (respiratory and circulatory function; basic life support): Pulse oximetry – continuous noninvasive measurement of arterial blood oxygen saturation and pulse rate. Positioning the patient on the bleeding side – so that endobronchial blood cannot enter unaffected lung segments In case of massive hemoptysis: securing the airway by endotracheal … Coughing Up Blood (Hemoptysis): Therapy
Pathogenesis (development of disease) Hemoptysis can occur as a result of various respiratory diseases. Etiology (Causes) Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Pulmonary AV malformation – malformations in the vascular system of the lungs. Respiratory system (J00-J99 Bronchiectasis (synonym: bronchiectasis) – persistent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may … Coughing Up Blood (Hemoptysis): Causes
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes and sclerae (white part of the eye). Examination of the lungs Auscultation (listening) of the lungs Bronchophony (checking the conduction of high-frequency sounds; the patient is … Coughing Up Blood (Hemoptysis): Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count (platelet count?). Differential blood count Inflammatory parameters – CRP (C-reactive protein) or PCT (procalcitonin). Coagulation parameters – PTT, Quick Laboratory parameters 2nd order – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnostic clarification. … Coughing Up Blood (Hemoptysis): Test and Diagnosis
Obligatory medical device diagnostics. X-ray of the thorax (radiographic thorax/chest), in two planes. Computed tomography of the thorax (thoracic CT) with CT angiography (imaging technique used to visualize blood vessels in the body)Localization finding: 63-100%; Cause finding: 60-77%. Optional medical device diagnostics – depending on the results of the medical history, physical examination, laboratory diagnostics … Coughing Up Blood (Hemoptysis): Diagnostic Tests
