1. H e m o p t y s i s Prepared by Dr. Tahany Mahmoud Banha Chest Department Banha University

2. References . Stedman TL. Stedman's Medical dictionary. 27th ed. Philidelphia: Lipincott Williams & Wilkins, 2000 . . Thompson AB, Teschler H, Rennard SI. Pathogenesis, evaluation, and therapy for massive hemoptysis. Clin Chest Med 1992;13:69-82 . . Knott-Craig CJ, Oostuizen JG, Rossouw G, Joubert JR, Barnard PM. Management and prognosis of massive hemoptysis. Recent experience with 120 patients. J Thorac Cardiovasc Surg 1993;105:394-7 . . Cahill BC, Ingbar DH. Massive hemoptysis. Assessment and management. Clin Chest Med 1994;15:147-67 . . Harrison TR, Braunwald E. Hemoptysis. In: Harrison's Principles of internal medicine. 15th ed. New York: McGraw-Hill

4. Hemoptysis Hemoptysis is coughing up blood from the respiratory tract. The blood can come from the nose, mouth, throat, the airway passages leading to the lungs. The word "hemoptysis" comes from the Greek "haima," meaning "blood," and "ptysis," which means "a spitting"

6. Massive Hemoptesis: It is the amount of blood that can not be cleared from the dead space (150ml). It is about 600ml blood/24 h X-sanguating Hemoptesis: Rate of bleeding >150ml/h

7. Pathophysiologic Factors: 1-Dual Circulation: The lungs have a dual blood supply. The pulmonary arterial circulation, a high-compliance, low-pressure system that terminates in the pulmonary capillary bed, is responsible for gas exchange.

8. In addition, the lungs are supplied by the bronchial arteries, branches of the aorta that bring nutrients to the lung parenchyma and major airways. The bronchial arteries, like all systemic arteries, are a high-pressure system. Most cases of hemoptysis result from disruption of branches of the bronchial arterial tree.

10. Causes Blood-tinged mucus in a healthy nonsmoker usually indicates a mild infection and is generally no cause for concern. Indeed, the most common cause of Hemoptysis is the least serious – a ruptured small blood vessel caused by coughing and/or a bronchitic infection In patients with a history of smoking or who are otherwise at risk for lung disease, however, Hemoptysis is often a sign of serious illness, including cancer

13. Cardiovascular Severe left ventricular heart failure Mitral stenosis Pulmonary embolism or infarction Septic pulmonary embolism or right-sided endocarditis Aortic aneurysm or bronchovascular fistula

14. Miscellaneous Idiopathic Pulmonary Hemosiderosis Aspirated foreign body Pulmonary contusion or trauma Posttransthoracic needle biopsy or transbronchial lung biopsy Factitious hemoptysis