- Hemoptysis is the expectoration of blood from the respiratory tract. The term comes from the Greek words haima, meaning blood, and ptysis, meaning spitting.
- Bleeding from the respiratory tract can range from blood-streaked sputum to massive hemoptysis from the lung. The amount and nature of bleeding should be characterized by taking a careful history.
- The source of bleeding can be anywhere in the respiratory tract, from the nose to the alveolus.
- Consequences of hemoptysis may include exsanguination, hypoxemia, and anemia or there may be none.
Large series of pediatric patients with massive hemoptysis have not been described.
- Related to the underlying pulmonary or cardiac disease
- Vascular origin of hemoptysis is from two locations:
- Pulmonary arteries: higher volume, lower pressure
- Bronchial arteries: lower volume, higher pressure
- More common causes:
- Infection (pneumonia, bronchitis, viral illnesses)
- Bronchiectasis leading to erosion into a bronchial artery
- Trauma (pulmonary contusion, bronchoscopy, airway manipulation)
- Foreign body aspiration
- Cystic fibrosis
- Congenital heart disease with collateral vessels or pulmonary hypertension
- Tracheostomy-related complications
- Less common causes:
- Cavitary infections (e.g., tuberculosis, abscess, histoplasmosis)
- Factitious hemoptysis
- Congenital vascular or airway lesions (pulmonary arteriovenous malformation, hemangioma, bronchogenic cyst, pulmonary sequestration)
- Hemorrhagic diathesis, including anticoagulant therapy
- H-type tracheoesophageal fistula
- Pulmonary embolism
- Pulmonary hemosiderosis
- Tumors (teratomas, lymphomas)
- Immune mediated: Henoch-Schönlein purpura, Goodpasture syndrome, Anti-neutrophil cytoplasmic antibody (ANCA)-associated granulomatous vasculitis, polyarteritis nodosa, systemic lupus erythematosus, Heiner syndrome
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Cabana, Michael D., editor. "Hemoptysis." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617426/all/Hemoptysis.
Hemoptysis. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617426/all/Hemoptysis. Accessed June 4, 2023.
Hemoptysis. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617426/all/Hemoptysis
Hemoptysis [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2023 June 04]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617426/all/Hemoptysis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hemoptysis ID - 617426 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617426/all/Hemoptysis PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -