The most common causes of hemoptysis are

The most common causes of hemoptysis are bronchial diseases, lung diseases, and cardiovascular diseases. Among them, tuberculosis among lung diseases is the most common cause of hemoptysis. Such hemoptysis is usually accompanied by fever, and the cause must be found in time for targeted treatment.

The most common cause of hemoptysis

1. Bronchial diseases (20%):

Common ones include bronchiectasis (tuberculous or non-tuberculous), chronic bronchitis, endobronchial tuberculosis, bronchial lung cancer, etc.; less common ones include benign bronchial tumors, endobronchial stones, nonspecific bronchial ulcers, etc.

2. Lung disease (25%):

Common causes include pulmonary tuberculosis, pneumonia, lung abscess, etc.; less common causes include pulmonary congestion, pulmonary infarction, lung metastasis, lung cysts, pulmonary fungal disease, paragonimiasis, etc. Tuberculosis is one of the most common causes of hemoptysis.

3. Cardiovascular disease (20%)

The most common type of hemoptysis is caused by mitral stenosis. Hemoptysis may also occur when certain congenital heart diseases such as atrial septal defect and patent ductus arteriosus cause pulmonary hypertension.

4. Others (10%):

Blood diseases (such as thrombocytopenic purpura, leukemia, hemophilia, etc.); acute infectious diseases (such as pulmonary hemorrhagic leptospirosis, epidemic hemorrhagic fever, etc.); connective tissue diseases (such as polyarteritis nodosa); endometriosis, etc.

2. Physical signs

The lungs should be examined in detail and percussion should be avoided. For example, when hemoptysis begins, the breath sounds of one lung are weakened or (and) Up sounds appear, while the breath sounds of the opposite lung field are good, which often indicates that the bleeding is on that side. Physical examination can also support some specific diagnoses. For example, a mitral diastolic murmur is conducive to the diagnosis of rheumatic heart disease; wheezing sounds in localized lung and bronchial areas often indicate endobronchial lesions, such as lung cancer or foreign bodies; vascular murmurs in the lung fields support arteriovenous malformations; clubbing is common in lung cancer, bronchiectasis and lung abscess; enlarged supraclavicular and anterior scalene lymph nodes support metastatic cancer.

3. Associated symptoms

(1) Hemoptysis with fever: can be seen in pulmonary tuberculosis, pneumonia, pulmonary hemorrhagic leptospirosis, epidemic hemorrhagic fever, bronchial lung cancer, etc.

(ii) Hemoptysis with chest pain: can be seen in lobar pneumonia, pulmonary infarction, pulmonary tuberculosis, bronchial lung cancer, etc.

(III) Pyrexia of blood and pus: This can be seen in lung abscess, cavitary tuberculosis, bronchiectasis, etc. Bronchiectasis can also cause repeated hemoptysis without sputum, which is called dry bronchiectasis.

(IV) Hemoptysis with choking cough: can be seen in bronchial lung cancer, mycoplasma pneumonia, etc.

(V) Hemoptysis accompanied by skin and mucous membrane bleeding: Pay attention to hemorrhagic fever and blood diseases.