Haemoptysis

Summary

• Haemoptysis is most commonly caused by pneumonia but also PE, lung Ca, and TB

• Important to distinguish haemoptysis from haematemasis and epistaxis

• Usually mild, requiring investigation into cause

• Nebulised tranexamic acid can be used if severe

Outline

Background

Source of bleeding

• 95% bronchial artery (supplies blood to be oxygenated)

• 5% pulmonary artery (supplied artieral blood to lung tissue)

Differentials

• Epistaxis

• Haematemasis (UGIB)

Diagnoses

Core

• Pneumonia

• Pulmonary Embolus

• Lung Cancer

• Tuberculosis

MCQ Answers (rare)

• Bronchiectasis 

• Vasculitis

  • Goodpasture's: normal CRP, haematoproteinuria

  • GPA: raised CRP, haematoproteinuria

  • Takayasu's Arteritis 

• Infective

  • Leptospirosis : foreign travel, septic

  • Aspergilloma: cavity on CT

Management

1. Stabilise

   • Nebulised tranexamic acid

2. Treat underlying cause

Resources and References

Written in 2025