Hemoptysis

Abstract

Hemoptysis is an alarming symptom which is distressing for patients and their families. Where possible it is best treated by addressing the underlying cause. Radiotherapy is usually effective in controlling hemoptysis from a bronchial carcinoma, for example. Massive hemoptysis is defined as >200 mls in 24 h. When a major vessel is eroded, bleeding may be catastrophic and rapidly fatal, and there is little to be done except to ensure that the patient is given medications such as benzodiazepines and opioids to relieve anxiety and breathlessness. If the patient survives, the initial bleed resuscitation is directed at maintaining the airway and circulatory volume. Most major bleeding arises from the bronchial arteries and bronchial artery embolization is usually effective in stopping bleeding by occluding the vascular supply.