Overview
Introduction
First establish where the blood came from. Blood produced after coughing and mixed with sputum supports hemoptysis, but it is not diagnostic by appearance alone.
First establish where the blood came from. Blood produced after coughing and mixed with sputum supports hemoptysis, but it is not diagnostic by appearance alone. Blood from the upper gastrointestinal tract is more likely to follow nausea or retching and may be dark or mixed with food. Blood from the nose, gums, mouth, or nasopharynx may be mistaken for pulmonary bleeding, particularly when it is swallowed and later expectorated. Ask the patient to describe the event in their own words, then clarify: - When did it begin, and is it a first episode, persistent bleeding, or recurrence? - How much blood was seen, how often, and were there clots or blood-streaked sputum? - Was it bright red, dark, frothy, or mixed with mucus? - Did coughing, vomiting, choking, chest pain, fever, or sudden dyspnea occur first? - Is there pleuritic chest pain, wheezing, night sweats, weight loss, or fatigue? - Has there been exposure to tuberculosis, recent travel, smoking, occupational inhalants, respiratory infection, or a recent procedure or injury? - Is the patient taking an anticoagulant, antiplatelet drug, or other...