Hemoptysis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with | Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes. Patients with hemoptysis usually appear anxious and depend on the severity of [[bleeding]] they might be critically ill. Patients with hemoptysis usually have abnormal [[vital signs]] indicating [[dehydration]], other signs of [[mucosal bleeding]], purulent bloody [[sputum]], and abnormal [[Respiratory examination|lung exam]] indicating underlying [[Lung|pulmonary]] causes. | ||
==Physical Examination== | ==Physical Examination== | ||
*Physical examination of patients with hemoptysis might be normal. However, patients might show findings depend on underlying causes.<ref name="LeeKim2015">{{cite journal|last1=Lee|first1=Myoung Kyu|last2=Kim|first2=Sang-Ha|last3=Yong|first3=Suk Joong|last4=Shin|first4=Kye Chul|last5=Kim|first5=Hyun Sik|last6=Yu|first6=Tae-Sun|last7=Choi|first7=Eun Hee|last8=Lee|first8=Won-Yeon|title=Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization|journal=The Clinical Respiratory Journal|volume=9|issue=1|year=2015|pages=53–64|issn=17526981|doi=10.1111/crj.12104}}</ref><ref name="KhalilFedida2015">{{cite journal|last1=Khalil|first1=A.|last2=Fedida|first2=B.|last3=Parrot|first3=A.|last4=Haddad|first4=S.|last5=Fartoukh|first5=M.|last6=Carette|first6=M.-F.|title=Severe hemoptysis: From diagnosis to embolization|journal=Diagnostic and Interventional Imaging|volume=96|issue=7-8|year=2015|pages=775–788|issn=22115684|doi=10.1016/j.diii.2015.06.007}}</ref><ref name="BruzziRémy-Jardin2006">{{cite journal|last1=Bruzzi|first1=John F.|last2=Rémy-Jardin|first2=Martine|last3=Delhaye|first3=Damien|last4=Teisseire|first4=Antoine|last5=Khalil|first5=Chadi|last6=Rémy|first6=Jacques|title=Multi–Detector Row CT of Hemoptysis|journal=RadioGraphics|volume=26|issue=1|year=2006|pages=3–22|issn=0271-5333|doi=10.1148/rg.261045726}}</ref> | *Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes.<ref name="LeeKim2015">{{cite journal|last1=Lee|first1=Myoung Kyu|last2=Kim|first2=Sang-Ha|last3=Yong|first3=Suk Joong|last4=Shin|first4=Kye Chul|last5=Kim|first5=Hyun Sik|last6=Yu|first6=Tae-Sun|last7=Choi|first7=Eun Hee|last8=Lee|first8=Won-Yeon|title=Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization|journal=The Clinical Respiratory Journal|volume=9|issue=1|year=2015|pages=53–64|issn=17526981|doi=10.1111/crj.12104}}</ref><ref name="KhalilFedida2015">{{cite journal|last1=Khalil|first1=A.|last2=Fedida|first2=B.|last3=Parrot|first3=A.|last4=Haddad|first4=S.|last5=Fartoukh|first5=M.|last6=Carette|first6=M.-F.|title=Severe hemoptysis: From diagnosis to embolization|journal=Diagnostic and Interventional Imaging|volume=96|issue=7-8|year=2015|pages=775–788|issn=22115684|doi=10.1016/j.diii.2015.06.007}}</ref><ref name="BruzziRémy-Jardin2006">{{cite journal|last1=Bruzzi|first1=John F.|last2=Rémy-Jardin|first2=Martine|last3=Delhaye|first3=Damien|last4=Teisseire|first4=Antoine|last5=Khalil|first5=Chadi|last6=Rémy|first6=Jacques|title=Multi–Detector Row CT of Hemoptysis|journal=RadioGraphics|volume=26|issue=1|year=2006|pages=3–22|issn=0271-5333|doi=10.1148/rg.261045726}}</ref> | ||
*Patients with hemoptysis usually appear anxious and depend on the severity of bleeding they might be critically ill. | *Patients with hemoptysis usually appear anxious and depend on the severity of [[bleeding]] they might be critically ill. | ||
*Patients with hemoptysis usually have abnormal vital signs indicating dehydration, other signs of mucosal bleeding, purulent bloody sputum, and abnormal lung exam indicating underlying pulmonary causes. | *Patients with hemoptysis usually have abnormal [[vital signs]] indicating [[dehydration]], other signs of [[mucosal bleeding]], purulent bloody [[sputum]], and abnormal [[Respiratory examination|lung exam]] indicating underlying [[Lung|pulmonary]] causes. | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
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===Vital Signs=== | ===Vital Signs=== | ||
*Low-grade fever | *Low-grade [[fever]] | ||
*[[Tachycardia]] with regular pulse | *[[Tachycardia]] with regular [[pulse]] | ||
*Tachypnea | *[[Tachypnea]] | ||
*Low blood pressure with normal pulse pressure | *[[Hypotension|Low blood pressure]] with normal [[pulse pressure]] | ||
===Skin=== | ===Skin=== | ||
*Bruises | *[[Bruise|Bruises]] | ||
*Telangiectasia | *[[Telangiectasia]] | ||
*Palpable purpura | *Palpable [[purpura]] | ||
*Rash | *[[Rash]] | ||
===HEENT=== | ===HEENT=== | ||
* Purulent bloody sputum | * Purulent bloody [[sputum]] | ||
===Neck=== | ===Neck=== | ||
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===Lungs=== | ===Lungs=== | ||
*Decreased chest expansion | *Decreased [[Respiratory examination|chest expansion]] | ||
*Coarse [[crackles]] upon auscultation of the lung bases unilaterally or bilaterally | *Coarse [[crackles]] upon [[auscultation]] of the [[lung]] bases unilaterally or bilaterally | ||
*Decreased breath sounds | *Decreased [[breath sounds]] | ||
*[[Wheezing]] may be present | *[[Wheezing]] may be present | ||
===Heart=== | ===Heart=== | ||
*[[ | *[[Heart murmur|Systolic murmur]] / [[diastolic murmur]] | ||
===Abdomen=== | ===Abdomen=== | ||
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===Back=== | ===Back=== | ||
* Back examination of patients with hemoptysis is usually normal. | * [[Human back|Back]] examination of patients with hemoptysis is usually normal. | ||
===Genitourinary=== | ===Genitourinary=== | ||
* Genitourinary examination of patients with hemoptysis is usually normal. | * [[Genitourinary system|Genitourinary]] examination of patients with hemoptysis is usually normal. | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
* Neuromuscular examination of patients with hemoptysis is usually normal. | * Neuromuscular examination of patients with hemoptysis is usually normal. | ||
===Extremities=== | ===Extremities=== | ||
* Peripheral edema | * [[Pedal edema|Peripheral edema]] | ||
* Clubbing of the digits | * [[Clubbing]] of the digits | ||
* Joint effusions | * [[Joint]] effusions | ||
* Periarticular warmth | * Periarticular warmth | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 21:59, 26 February 2018
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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]
Overview
Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes. Patients with hemoptysis usually appear anxious and depend on the severity of bleeding they might be critically ill. Patients with hemoptysis usually have abnormal vital signs indicating dehydration, other signs of mucosal bleeding, purulent bloody sputum, and abnormal lung exam indicating underlying pulmonary causes.
Physical Examination
- Physical examination of patients with hemoptysis might be normal. However, patients might show different findings depend on underlying causes.[1][2][3]
- Patients with hemoptysis usually appear anxious and depend on the severity of bleeding they might be critically ill.
- Patients with hemoptysis usually have abnormal vital signs indicating dehydration, other signs of mucosal bleeding, purulent bloody sputum, and abnormal lung exam indicating underlying pulmonary causes.
Appearance of the Patient
- Patients with hemoptysis usually appear anxious.
- Patients with massive hemoptysis usually appear critically ill.
Vital Signs
- Low-grade fever
- Tachycardia with regular pulse
- Tachypnea
- Low blood pressure with normal pulse pressure
Skin
- Bruises
- Telangiectasia
- Palpable purpura
- Rash
HEENT
- Purulent bloody sputum
Neck
Lungs
- Decreased chest expansion
- Coarse crackles upon auscultation of the lung bases unilaterally or bilaterally
- Decreased breath sounds
- Wheezing may be present
Heart
Abdomen
Back
- Back examination of patients with hemoptysis is usually normal.
Genitourinary
- Genitourinary examination of patients with hemoptysis is usually normal.
Neuromuscular
- Neuromuscular examination of patients with hemoptysis is usually normal.
Extremities
- Peripheral edema
- Clubbing of the digits
- Joint effusions
- Periarticular warmth
References
- ↑ Lee, Myoung Kyu; Kim, Sang-Ha; Yong, Suk Joong; Shin, Kye Chul; Kim, Hyun Sik; Yu, Tae-Sun; Choi, Eun Hee; Lee, Won-Yeon (2015). "Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization". The Clinical Respiratory Journal. 9 (1): 53–64. doi:10.1111/crj.12104. ISSN 1752-6981.
- ↑ Khalil, A.; Fedida, B.; Parrot, A.; Haddad, S.; Fartoukh, M.; Carette, M.-F. (2015). "Severe hemoptysis: From diagnosis to embolization". Diagnostic and Interventional Imaging. 96 (7–8): 775–788. doi:10.1016/j.diii.2015.06.007. ISSN 2211-5684.
- ↑ Bruzzi, John F.; Rémy-Jardin, Martine; Delhaye, Damien; Teisseire, Antoine; Khalil, Chadi; Rémy, Jacques (2006). "Multi–Detector Row CT of Hemoptysis". RadioGraphics. 26 (1): 3–22. doi:10.1148/rg.261045726. ISSN 0271-5333.