Hemoptysis pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]


Lung has two main vascular systems that include pulmonary circulation and bronchial circulation. There are multiple anastomoses between pulmonary and bronchial arteries which create physiologic right to left shunts. Blood in the hemoptysis is mostly originated from the Lung. However, it could be from the gastrointestinal system as well. Primary origin of the blood comes from bronchial arteries. However, other sources of bleeding might be pulmonary vessels, aorta, intercostal, coronary, thoracic, and phrenic arteries. Hemoptysis is an important symptom that has different etiologies and pathogenesis mechanisms. Hemoptysis may happen following infarction and ischemia of pulmonary parenchyma as seen in pulmonary embolism, vasculitis, and infections. Another mechanism of hemoptysis is vascular engorgement with erosion as seen in bronchitis, bronchiectasis, and toxic exposure to cigarette and other irritants. In some cases underlying cause can not be identified and they are considered as idiopathic. However, they might present with massive hemoptysis. There are multiple conditions that are associated with hemoptysis which include granulomatosis with polyangiitis, sarcoidosis, immunodeficiency, and indoor ice hockey play.



Illustration from Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013. By OpenStax College - Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0,[1]
This slide shows the arterial and venous blood circulation of the pulmonary system. By Artwork by Holly Fischer - http://open.umich.edu/education/med/resources/second-look-series/materials - Respiratory Tract Slide 20, CC BY 3.0,[2]



Associated Conditions


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