Hemoptysis

The expectoration of blood originating from the lower respiratory tract, typically from the tracheobronchial tree or pulmonary parenchyma, and distinguished from bleeding originating from the nasopharynx (pseudohemoptysis) or gastrointestinal tract (hematemesis).

Causes

• Infectious causes

  • Acute bronchitis

  • Pneumonia

  • Tuberculosis

  • Fungal infections

• Chronic pulmonary diseases

  • Chronic obstructive pulmonary disease (COPD)

  • Cystic fibrosis

  • Bronchiectasis

• Malignant causes

  • Primary lung cancer

  • Pulmonary metastases

  • Endobronchial tumors

• Cardiovascular causes

  • Pulmonary embolism

  • Heart failure causing pulmonary venous congestion

  • Mitral valve disease

  • Pulmonary hypertension

• Traumatic and iatrogenic causes

  • Chest trauma

  • Bronchoscopy

  • Foreign body injury

  • Inhalational injury: Inhaled irritants, crack cocaine

• Coagulopathy

  • Medications: Anticoagulants, antiplatelet

  • Coagulation disorders

• Autoimmune and inflammatory causes

  • Vasculitis

  • Goodpasture's syndrome (anti-GBM disease)

  • Systemic lupus erythematosus (SLE)

  • Granulomatosis with polyangiitis

• Thoracic endometriosis (catamenial hemoptysis)

• Pulmonary arteriovenous malformations