Current strategies for diagnosing and managing hemoptysis

Hemoptysis may indicate serious underlying disease and calls for a prompt work-up, including evaluation of the amount of bleeding. Begin by verifying that the bleeding originates below the larynx. Review the chest film for fibrocavitary disease, atelectasis, masses, ring shadows, and Kerley's B lines. Bronchoscopy and laboratory data may yield additional clues. Treatment depends on the rate of bleeding. In mild and moderate cases, use of antibiotics may suffice. Massive hemoptysis, though rare, poses the risk of asphyxiation and requires immediate action, possibly including surgery.