№ 14Differential Diagnostic Topics12 min read
Differential diagnosis of hemoptysis
1. Big picture
Hemoptysis = coughing up blood from the lower respiratory tract. In the exam, the first question is not “what is the cause?” but:
Is this true hemoptysis, is it massive/life-threatening, and can the patient protect the airway?
The dangerous causes to exclude early are:
- Lung cancer
- Tuberculosis
- Bronchiectasis
- Pulmonary embolism with infarction
- Diffuse alveolar hemorrhage
- Goodpasture syndrome / ANCA vasculitis
- Severe pneumonia or lung abscess
- Anticoagulant-related bleeding
- Aspergilloma
- Mitral stenosis / pulmonary venous hypertension
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