Dr. Huntley's
Diagnosis
Checklist
Have a symptom?
See what questions
a doctor would ask.
See what questions
a doctor would ask.
Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Lung cancer) that could possibly cause Lung cancer includes:
More causes: see full list of causes for Lung cancer
The following conditions have been cited in various sources as potentially causal risk factors related to Lung cancer:
The following medical statistics relate to risk factors for Lung cancer:
To research the causes of Lung cancer, consider researching the causes of these these diseases that may be similar, or associated with Lung cancer:
Causes of Types of Lung cancer: Review the cause informationfor the various types of Lung cancer:
Causes of Broader Categories of Lung cancer: Review the causal information about the various more general categories of medical conditions:
Other conditions that might have Lung cancer as a complication may, potentially, be an underlying cause of Lung cancer. Our database lists the following as having Lung cancer as a complication of that condition:
Conditions listing Lung cancer as a symptom may also be potential underlying causes of Lung cancer. Our database lists the following as having Lung cancer as a symptom of that condition:
Article excerpts about the
causes of Lung cancer:
87% of lung cancer is caused by smoking, so what about the other 13%?
There is evidence that exposure to tobacco smoke in the home, usually from
a smoking spouse, may increase the risk of lung cancer in non-smoking
women. Nearly 9 out of 10 non-smoking Americans are exposed to
environmental tobacco smoke (also known as "second-hand" smoke), as
measured by levels of nicotine in their blood. The best scientific studies
show that restrictions on second hand smoke reduce the risk of death and
injury to non-smokers, including the hundreds of thousands of children
with asthma and other respiratory illness. The FDA has classified
second-hand smoke as a Group A carcinogen (known to cause cancer in
humans.) Studies have also evaluated environmental tobacco exposure
outside the home, either in a work or social setting but they provide
inconclusive results. More studies are needed to determine how much
exposure might be harmful in any of these settings. (Source: excerpt from Lung Cancer: NWHIC)
The following medical news items are relevant to causes of Lung cancer:
The following are statistics from various sources about the causes of Lung cancer:
As with all medical conditions, there may be many causal factors. Further relevant information on causes of Lung cancer may be found in:
16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Lung cancer.
Source: In a Page: Signs and Symptoms, 2004
Source: In A Page: Pediatric Signs and Symptoms, 2007
Bronchial adenoma is an insidious disorder that causes recurring hemoptysis in up to 30% of patients, along with a chronic cough and local wheezing.
Inflamed bronchial surfaces and eroded bronchial blood vessels cause hemoptysis, which can vary from blood-tinged sputum to blood (in about 20% of cases) The patient’s sputum may also be copious, foul-smelling, and purulent
He may exhibit a chronic cough, coarse crackles, clubbing (a late sign), a fever, weight loss, fatigue, weakness, malaise, and dyspnea on exertion.
The first sign of chronic bronchitis is typically a productive cough that lasts at least 3 months Eventually this leads to the production of blood-streaked sputum; massive hemorrhage is unusual
Other respiratory effects include dyspnea, prolonged expirations, wheezing, scattered rhonchi, accessory muscle use, barrel chest, tachypnea, and clubbing (a late sign).
Such disorders as thrombocytopenia and disseminated intravascular coagulation can cause hemoptysis Besides their specific related findings, these disorders may share such general signs as multisystem hemorrhaging (for example, GI bleeding or epistaxis) and purpuric lesions.
In about 50% of patients, lung abscess produces blood-streaked sputum resulting from bronchial ulceration, necrosis, and granulation tissue Common associated findings include a cough with large amounts of purulent, foul-smelling sputum; a fever with chills; diaphoresis; anorexia; weight loss; a headache; weakness; dyspnea; pleuritic or dull chest pain; and clubbing
Auscultation reveals tubular or cavernous breath sounds and crackles. Percussion reveals dullness on the affected side.
Ulceration of the bronchus commonly causes recurring hemoptysis (an early sign), which can vary from blood-streaked sputum to blood Related findings include a productive cough, dyspnea, a fever, anorexia, weight loss, wheezing, and chest pain (a late symptom).
In up to 50% of cases, Klebsiella pneumonia produces dark brown or red (currant jelly) sputum, which is so tenacious that the patient has difficulty expelling it from his mouth This type of pneumonia begins abruptly with chills, a fever, dyspnea, a productive cough, and severe pleuritic chest pain
Associated findings may include cyanosis, prostration, tachycardia, decreased breath sounds, and crackles.
Pneumococcal pneumonia causes pinkish or rusty mucoid sputum. It begins with sudden, shaking chills; a rapidly rising temperature; and, in over 80% of cases, tachycardia and tachypnea. Within a few hours, the patient typically experiences a productive cough along with severe, stabbing, pleuritic pain. The agonizing chest pain leads to rapid, shallow, grunting respirations with splinting. Examination reveals respiratory distress with dyspnea and accessory muscle use, crackles, and dullness on percussion over the affected lung. Malaise, weakness, myalgia, and prostration accompany a high fever.
Severe cardiogenic or noncardiogenic pulmonary edema commonly causes frothy, blood-tinged pink sputum, which accompanies severe dyspnea, orthopnea, gasping, anxiety, cyanosis, diffuse crackles, a ventricular gallop, and cold, clammy skin This life-threatening condition may also cause tachycardia, lethargy, cardiac arrhythmias, tachypnea, hypotension, and a thready pulse.
Hemoptysis is a common finding in pulmonary embolism with infarction, a life-threatening disorder, although massive hemoptysis is infrequent Typical initial symptoms are dyspnea and anginal or pleuritic chest pain
Other common clinical features include tachycardia, tachypnea, a low-grade fever, and diaphoresis. Less commonly, splinting of the chest, leg edema, and — with a large embolus — cyanosis, syncope, and jugular vein distention may occur. Examination reveals decreased breath sounds, a pleural friction rub, crackles, diffuse wheezing, dullness on percussion, and signs of circulatory collapse (a weak, rapid pulse; hypotension), cerebral ischemia (transient loss of consciousness, convulsions), and hypoxemia (restlessness and, particularly in elderly patients, hemiplegia and other focal neurologic deficits).
Features generally develop late Hemoptysis, exertional dyspnea, and fatigue are common
Angina-like pain usually occurs with exertion and may radiate to the neck but not to the arms. Other findings include arrhythmias, syncope, a cough, and hoarseness.
Blood-streaked or blood-tinged sputum commonly occurs in pulmonary TB; massive hemoptysis may occur in advanced cavitary TB
Accompanying respiratory findings include a chronic productive cough, fine crackles after coughing, dyspnea, dullness on percussion, increased tactile fremitus, and possible amphoric breath sounds. The patient may also develop night sweats, malaise, fatigue, a fever, anorexia, weight loss, and pleuritic chest pain.
In 50% of patients with SLE, pleuritis and pneumonitis cause hemoptysis, a cough, dyspnea, pleuritic chest pain, and crackles
Related findings are a butterfly rash in the acute phase, nondeforming joint pain and stiffness, photosensitivity, Raynaud’s phenomenon, seizures or psychoses, anorexia with weight loss, and lymphadenopathy.
Torn tracheal mucosa may cause hemoptysis, hoarseness, dysphagia, neck pain, airway occlusion, and respiratory distress.
Lung or airway injury from bronchoscopy, laryngoscopy, mediastinoscopy, or lung biopsy can cause bleeding and hemoptysis.
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Researchers have found that cancer develops from mutations within the genes of cells. Thus, cancer is a genetic disease. Cancer susceptibility genes are of two types. Some are oncogenes, which activate cell division and influence embryonic development, and some are tumor suppressor genes, which halt cell division.
These genes are typically found in normal human cells, but certain kinds of mutations may transform the normal cells. Inherited defects may cause a genetic mutation, whereas exposure to a carcinogen may cause an acquired mutation. Current evidence indicates that carcinogenesis results from a complex interaction of carcinogens and accumulated mutations in several genes.
In animal studies of the ability of viruses to transform cells, some human viruses exhibit carcinogenic potential. For example, the Epstein-Barr virus, the cause of infectious mononucleosis, has been linked to Burkitt's lymphoma and nasopharyngeal cancer.
High-frequency radiation, such as ultraviolet and ionizing radiation, damages the genetic material known as deoxyribonucleic acid (DNA), possibly inducing genetically transferable abnormalities. Other factors, such as a person's tissue type and hormonal status, interact to potentiate radiation's carcinogenic effect. Examples of substances that may damage DNA and induce carcinogenesis include:
❑alkylating agents — leukemia
❑aromatic hydrocarbons and benzopyrene (from polluted air) — lung cancer
❑asbestos — mesothelioma of the lung
❑tobacco — cancer of the lung, oral cavity and upper airways, esophagus, pancreas, kidneys, and bladder
❑vinyl chloride — angiosarcoma of the liver.
Diet has also been implicated, especially in the development of GI cancer as a result of a high animal fat diet. Additives composed of nitrates and certain methods of food preparation — particularly charbroiling — are also recognized factors.
The role of hormones in carcinogenesis is still controversial, but it seems that excessive use of some hormones, especially estrogen, produces cancer in animals. Also, the synthetic estrogen diethylstilbestrol causes vaginal cancer in some daughters of women who were treated with it. It's unclear, however, whether changes in human hormonal balance retard or stimulate cancer development.
Some forms of cancer and precancerous lesions result from genetic predisposition either directly (as in Wilms' tumor and retinoblastoma) or indirectly (in association with inherited conditions such as Down syndrome or immunodeficiency diseases). Expressed as autosomal recessive, X-linked, or autosomal dominant disorders, their common characteristics include:
❑early onset of malignant disease
❑increased incidence of bilateral cancer in paired organs (breasts, adrenal glands, kidneys, and eighth cranial nerve [acoustic neuroma])
❑increased incidence of multiple primary malignancies in nonpaired organs
❑abnormal chromosome complement in tumor cells.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Most experts agree that lung cancer is attributable to inhalation of carcinogenic pollutants by a susceptible host. Who's most susceptible? Any smoker older than age 40, especially if he began to smoke before age 15, has smoked a whole pack or more per day for 20 years, or works with or near asbestos.
Pollutants in tobacco smoke cause progressive lung cell degeneration. Lung cancer is 10 times more common in smokers than in nonsmokers; 80% of patients with lung cancer are smokers. Cancer risk is determined by the number of cigarettes smoked daily, the depth of inhalation, how early in life smoking began, and the nicotine content of cigarettes. Two other factors also increase susceptibility: exposure to carcinogenic industrial and air pollutants (asbestos, uranium, arsenic, nickel, iron oxides, chromium, radioactive dust, and coal dust) and familial susceptibility.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Primary tumors of the spinal cord may be extramedullary (occurring outside the spinal cord) or intramedullary (occurring within the cord itself). Extramedullary tumors may be intradural (meningiomas and schwannomas), which account for 60% of all primary malignant spinal cord neoplasms, or extradural (metastatic tumors from breasts, lungs, prostate, leukemia, or lymphomas), which account for 25% of these malignant neoplasms.
Intramedullary tumors, or gliomas (astrocytomas or ependymomas), are comparatively rare, accounting for only about 10%. In children, they're low-grade astrocytomas.
Spinal cord tumors are rare compared with intracranial tumors (ratio of 1:4). They occur equally in men and women, with the exception of meningiomas, which occur mostly in women. Spinal cord tumors can occur anywhere along the length of the cord or its roots.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Rarely, an aortic aneurysm ruptures into the tracheobronchial tree, causing hemoptysis and sudden death.
Although individuals with this type of injury may not have obvious external chest injuries, they sometimes show other indications of internal damage, such as hemoptysis. Health care providers should evaluate survivors of explosive detonations for other classic signs and symptoms of a blast lung injury, such as chest pain, cyanosis, dyspnea, and wheezing. Treatment includes careful administration of fluids and oxygen to ensure tissue perfusion.
This insidious disorder causes recurring hemoptysis in up to 30% of patients along with a chronic cough and local wheezing.
Inflamed bronchial surfaces and eroded bronchial blood vessels cause hemoptysis, which can vary from blood-tinged sputum to blood (in about 20% of patients). The patient typically has a chronic cough producing copious amounts of foul-smelling, purulent sputum. He may also exhibit coarse crackles, clubbing (a late sign), fever, weight loss, fatigue, weakness, malaise, and dyspnea on exertion.
The first sign of this disorder is typically a productive cough that lasts at least 3 months. Eventually this leads to production of blood-streaked sputum; massive hemorrhage is unusual. Other respiratory effects include dyspnea, prolonged expirations, wheezing, scattered rhonchi, accessory muscle use, barrel chest, tachypnea, and clubbing (a late sign).
Such disorders as thrombocytopenia and disseminated intravascular coagulation can cause hemoptysis, multisystem hemorrhaging (for example, GI bleeding or epistaxis), and purpuric lesions.
Hemoptysis occurs in this cancer, but hoarseness is usually the initial sign. Other findings may include dysphagia, dyspnea, stridor, cervical lymphadenopathy, and neck pain.
In about 50% of patients, this disorder produces blood-streaked sputum resulting from bronchial ulceration, necrosis, and granulation tissue. Common associated findings include a cough producing large amounts of purulent, foul-smelling sputum; fever with chills; diaphoresis; anorexia; weight loss; headache; weakness; dyspnea; pleuritic or dull chest pain; and clubbing. Auscultation reveals tubular or cavernous breath sounds and crackles. Percussion reveals dullness on the affected side.
Ulceration of the bronchus commonly causes recurring hemoptysis (an early sign), which can vary from blood-streaked sputum to blood. Related findings include a productive cough, dyspnea, fever, anorexia, weight loss, wheezing, and chest pain (a late symptom).
The pneumonic form of this acute bacterial infection, caused by Yersinia pestis, can produce hemoptysis, a productive cough, chest pain, tachypnea, dyspnea, increasing respiratory distress, and cardiopulmonary insufficiency. Pneumonic plague begins abruptly with chills, fever, headache, and myalgia.
In up to 50% of patients, Klebsiella pneumonia produces dark brown or red (currant-jelly) sputum, which is so tenacious that the patient has difficulty expelling it from his mouth. This type of pneumonia begins abruptly with chills, fever, dyspnea, a productive cough, and severe pleuritic chest pain. Associated findings may include cyanosis, prostration, tachycardia, decreased breath sounds, and crackles.
Pneumococcal pneumonia causes pinkish or rusty mucoid sputum. It begins with sudden shaking chills; a rapidly rising temperature; and, in over 80% of patients, tachycardia and tachypnea. Within a few hours, the patient typically experiences a productive cough along with severe, stabbing, pleuritic pain that leads to rapid, shallow, grunting respirations with splinting. Examination reveals respiratory distress with dyspnea and accessory muscle use, crackles, and dullness on percussion over the affected lung. Malaise, weakness, myalgia, and prostration accompany a high fever.
Occurring in young adults, this genetic disorder causes intermittent hemoptysis along with cyanosis, clubbing, mild dyspnea, fatigue, vertigo, syncope, confusion, and speech and visual impairments. The patient may bleed from the nose, mouth, or lips. Ruby red patches appear on the face, tongue, skin, mucous membranes, or nail beds.
Blunt chest trauma commonly causes a cough with hemoptysis. Other signs and symptoms that appear over several hours include dyspnea, tachypnea, chest pain, tachycardia, hypotension, crackles, and decreased or absent breath sounds over the affected area. Severe respiratory distress—with oppressive dyspnea, nasal flaring, use of accessory muscles, extreme anxiety, cyanosis, and diaphoresis—may develop at any time.
Severe cardiogenic or noncardiogenic pulmonary edema commonly causes frothy, blood-tinged pink sputum, which accompanies severe dyspnea, orthopnea, gasping, anxiety, cyanosis, diffuse crackles, a ventricular gallop, and cold, clammy skin. This life-threatening condition may also cause tachycardia, lethargy, cardiac arrhythmias, tachypnea, hypotension, and a thready pulse.
Hemoptysis is a common finding in this life-threatening disorder, although massive hemoptysis is rare. Typical initial symptoms are dyspnea and anginal or pleuritic chest pain. Other common clinical features include tachycardia, tachypnea, low-grade fever, and diaphoresis. Less common features include splinting of the chest, leg edema, and—with a large embolus—cyanosis, syncope, and jugular vein distention. Examination reveals decreased breath sounds, pleural friction rub, crackles, diffuse wheezing, dullness on percussion, and signs of circulatory collapse (weak, rapid pulse and hypotension), cerebral ischemia (transient loss of consciousness and seizures), and hypoxemia (restlessness and, particularly in elderly patients, hemiplegia and other focal neurologic deficits).
Hemoptysis, exertional dyspnea, and fatigue generally develop late in this disorder. Angina-like pain usually occurs with exertion and may radiate to the neck but not to the arms. Other findings include arrhythmias, syncope, cough, and hoarseness.
Blood-streaked or blood-tinged sputum commonly occurs in this disorder; massive hemoptysis may occur in advanced cavitary tuberculosis. Accompanying respiratory findings include a chronic productive cough, fine crackles after coughing, dyspnea, dullness on percussion, increased tactile fremitus and, possibly, amphoric breath sounds. The patient may also develop night sweats, malaise, fatigue, fever, anorexia, weight loss, and pleuritic chest pain.
This chronic disorder causes a productive cough with mucopurulent sputum that later becomes blood streaked. Occasionally, massive hemoptysis may occur. Other findings include fine end-inspiratory crackles at lung bases, exertional dyspnea, tachypnea, weight loss, fatigue, and weakness.
In 50% of patients with this disorder, pleuritis and pneumonitis cause hemoptysis, a cough, dyspnea, pleuritic chest pain, and crackles. Related findings are a butterfly rash in the acute phase, nondeforming joint pain and stiffness, photosensitivity, Raynaud’s phenomenon, seizures or psychoses, anorexia with weight loss, and lymphadenopathy.
Torn tracheal mucosa may cause hemoptysis, hoarseness, dysphagia, neck pain, airway occlusion, and respiratory distress.
Necrotizing, granulomatous vasculitis characterizes this multisystem disorder. Findings include hemoptysis, chest pain, cough, wheezing, dyspnea, epistaxis, severe sinusitis, and hemorrhagic skin lesions.
Lung or airway injury from bronchoscopy, laryngoscopy, mediastinoscopy, or lung biopsy can cause bleeding and hemoptysis.
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
❑ Bronchitis
❑ Pneumonia
❑ Pulmonary edema
❑ Pulmonary infarction
❑ Tuberculosis
❑ Bronchogenic carcinoma
❑ Chest trauma
❑ Bronchiectasis
❑ Bronchial adenoma
❑ A-V malformation
❑ Aspergilloma
❑ Vasculitis
❑ Lung abscess
❑ Mitral stenosis
❑ Hereditary hemorrhagic telangiectasia
❑ Parasitic
Source: Field Guide to Bedside Diagnosis, 2007
Most experts agree that lung cancer is attributable to inhalation of carcinogenic pollutants by a susceptible host. Most susceptible are those persons who smoke or who work with or near asbestos.
Pollutants in tobacco smoke cause progressive lung cell degeneration. Lung cancer is 10 times more common in smokers than in nonsmokers; indeed, 80% of lung cancer patients are or were smokers.
Cancer risk is determined by the number of cigarettes smoked daily, the depth of inhalation, how early in life smoking began, and the nicotine content of the cigarettes. Two other factors also increase susceptibility: exposure to carcinogenic industrial and air pollutants (asbestos, uranium, arsenic, nickel, iron oxides, chromium, radioactive dust, and coal dust), and familial susceptibility.
Source: Handbook of Diseases, 2003
Rarely, an aortic aneurysm ruptures into the tracheobronchial tree, causing hemoptysis and sudden death.
Inflamed bronchial surfaces and eroded bronchial blood vessels cause hemoptysis, which can vary from blood-tinged sputum to blood (in about 20% of patients). The patient’s sputum may also be copious, foul-smelling, and purulent. He may exhibit a chronic cough, coarse crackles, clubbing (a late sign), fever, weight loss, fatigue, weakness, malaise, and dyspnea on exertion.
The first sign of bronchitis is typically a productive cough that lasts at least 3 months. Eventually this leads to production of blood-streaked sputum; massive hemorrhage is unusual. Other respiratory effects include dyspnea, prolonged expirations, wheezing, scattered rhonchi, accessory muscle use, barrel chest, tachypnea, and clubbing (a late sign).
Such disorders as thrombocytopenia and disseminated intravascular coagulation can cause hemoptysis. Besides their specific related findings, coagulation disorders may share such general signs as multisystem hemorrhaging (for example, GI bleeding or epistaxis) and purpuric lesions.
Hemoptysis occurs in laryngeal cancer, but hoarseness is the usual early sign. Other findings may include dysphagia, dyspnea, stridor, cervical lymphadenopathy, and neck pain.
In about 50% of patients, lung abscess produces blood-streaked sputum resulting from bronchial ulceration, necrosis, and granulation tissue. Common associated findings include a cough with large amounts of purulent, foul-smelling sputum; fever with chills; diaphoresis; anorexia; weight loss; headache; weakness; dyspnea; pleuritic or dull chest pain; and clubbing. Auscultation reveals tubular or cavernous breath sounds and crackles. Percussion reveals dullness on the affected side.
Ulceration of the bronchus commonly causes recurring hemoptysis (an early sign), which can vary from blood-streaked sputum to blood. Related findings include a productive cough, dyspnea, fever, anorexia, weight loss, wheezing, and chest pain (a late symptom).
Pneumococcal pneumonia causes pinkish or rusty mucoid sputum. It begins with sudden shaking chills; a rapidly rising temperature; and, in more than 80% of patients, tachycardia and tachypnea. Within a few hours, the patient typically experiences a productive cough along with severe, stabbing, pleuritic pain. The agonizing chest pain leads to rapid, shallow, grunting respirations with splinting. Examination reveals respiratory distress with dyspnea and accessory muscle use, crackles, and dullness on percussion over the affected lung. Malaise, weakness, myalgia, and prostration accompany high fever.
Occurring in young adults, pulmonary arteriovenous fistula causes intermittent hemoptysis. Associated signs and symptoms include cyanosis, clubbing, mild dyspnea, fatigue, vertigo, syncope, confusion, and speech and visual impairments. The patient may bleed from the nose, mouth, or lips. Ruby red patches appear on the face, tongue, skin, mucous membranes, or nail beds.
Blunt chest trauma commonly causes a cough with hemoptysis. Other signs and symptoms appear gradually within several hours after the injury and include dyspnea, tachypnea, chest pain, tachycardia, hypotension, crackles, and decreased or absent breath sounds over the affected area. Severe respiratory distress — with oppressive dyspnea, nasal flaring, use of accessory muscles, extreme anxiety, cyanosis, and diaphoresis — may develop at any time.
Severe cardiogenic or noncardiogenic pulmonary edema commonly causes frothy, blood-tinged pink sputum, which accompanies severe dyspnea, orthopnea, gasping, anxiety, cyanosis, diffuse crackles, a ventricular gallop, and cold, clammy skin. This life-threatening condition may also cause tachycardia, lethargy, cardiac arrhythmias, tachypnea, hypotension, and a thready pulse.
Hemoptysis is a common finding in pulmonary embolism with infarction — a life-threatening disorder — although massive hemoptysis is infrequent. Typical initial symptoms are dyspnea and anginal or pleuritic chest pain. Other common clinical features include tachycardia, tachypnea, low-grade fever, and diaphoresis. Less commonly, splinting of the chest, leg edema, and — with a large embolus — cyanosis, syncope, and distended jugular veins may occur. Examination reveals decreased breath sounds, pleural friction rub, crackles, diffuse wheezing, dullness on percussion, and signs of circulatory collapse (weak, rapid pulse; hypotension), cerebral ischemia (transient loss of consciousness, convulsions), and hypoxemia (restlessness and, particularly in elderly patients, hemiplegia and other focal neurologic deficits).
Features generally develop late. Hemoptysis, exertional dyspnea, and fatigue are common. Angina-like pain usually occurs with exertion and may radiate to the neck but not to the arms. Other findings include arrhythmias, syncope, cough, and hoarseness.
Blood-streaked or blood-tinged sputum commonly occurs in pulmonary tuberculosis; massive hemoptysis may occur in advanced cavitary tuberculosis. Accompanying respiratory findings include a chronic productive cough, fine crackles after coughing, dyspnea, dullness to percussion, increased tactile fremitus, and possible amphoric breath sounds. The patient may also develop night sweats, malaise, fatigue, fever, anorexia, weight loss, and pleuritic chest pain.
Initially, silicosis — a chronic disorder — causes a productive cough with mucopurulent sputum. Subsequently, the sputum becomes blood-streaked and, occasionally, massive hemoptysis may occur. Other findings include fine, end-inspiratory crackles at lung bases, exertional dyspnea, tachypnea, weight loss, fatigue, and weakness.
Torn tracheal mucosa may cause hemoptysis, hoarseness, dysphagia, neck pain, airway occlusion, and respiratory distress.
Necrotizing, granulomatous vasculitis characterizes Wegener’s granulomatosis — a multisystem disorder. Findings include hemoptysis, chest pain, cough, wheezing, dyspnea, epistaxis, severe sinusitis, and hemorrhagic skin lesions.
Lung or airway injury from bronchoscopy, laryngoscopy, mediastinoscopy, or lung biopsy can cause bleeding and hemoptysis.
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Bronchial adenoma is an insidious disorder that causes recurring hemoptysis along with a chronic cough and local wheezing. The patient with bronchial adenoma may also have recurrent infection, dyspnea, and wheezing.
With bronchiectasis, inflamed bronchial surfaces and eroded bronchial blood vessels cause hemoptysis, which can vary from blood-tinged sputum to blood (in about 20% of patients). The patient’s sputum may also be copious, foul-smelling, and purulent. He may exhibit a chronic cough, coarse crackles, clubbing (a late sign), fever, weight loss, fatigue, weakness, malaise, and dyspnea on exertion.
The first sign of chronic bronchitis is typically a productive cough that lasts at least 3 months. Eventually this leads to production of blood-streaked sputum; massive hemorrhage is unusual. Other respiratory effects include dyspnea, prolonged expirations, wheezing, scattered rhonchi, accessory muscle use, barrel chest, tachypnea, and clubbing (a late sign).
Such coagulation disorders as thrombocytopenia and disseminated intravascular coagulation can cause hemoptysis. In addition to their specific related findings, coagulation disorders may share such general signs as multisystem hemorrhaging (for example, GI bleeding or epistaxis) and purpuric lesions.
Hemoptysis occurs in laryngeal cancer, but hoarseness is the usual early sign. Other findings may include dysphagia, dyspnea, stridor, cervical lymphadenopathy, and neck pain.
In about 50% of patients, a lung abscess produces blood-streaked sputum resulting from bronchial ulceration, necrosis, and granulation tissue. Common associated findings include a cough with large amounts of purulent, foul-smelling sputum; fever with chills; diaphoresis; anorexia; weight loss; headache; weakness; dyspnea; pleuritic or dull chest pain; and clubbing. Auscultation reveals tubular or cavernous breath sounds and crackles. Percussion reveals dullness on the affected side.
In patients with lung cancer, ulceration of the bronchus commonly causes recurring hemoptysis (an early sign), which can vary from blood-streaked sputum to blood. Related findings include a productive cough, dyspnea, fever, anorexia, weight loss, wheezing, and chest pain (a late symptom).
In up to 50% of patients, Klebsiella pneumonia produces dark brown or red (currant-jelly) sputum, which is so tenacious that the patient has difficulty expelling it from his mouth. This type of pneumonia begins abruptly with chills, fever, dyspnea, a productive cough, and severe pleuritic chest pain. Associated findings may include cyanosis, prostration, tachycardia, decreased breath sounds, and crackles.
Pneumococcal pneumonia causes pinkish or rusty mucoid sputum. It begins with sudden shaking chills; a rapidly rising temperature; and, in over 80% of patients, tachycardia and tachypnea. Within a few hours, the patient typically experiences a productive cough along with severe, stabbing, pleuritic pain. The agonizing chest pain leads to rapid, shallow, grunting respirations with splinting. Examination reveals respiratory distress with dyspnea and accessory muscle use, crackles, and dullness on percussion over the affected lung. Malaise, weakness, myalgia, and prostration accompany high fever.
Pulmonary contusion, resulting from blunt chest trauma, commonly causes a cough with hemoptysis. Other signs and symptoms appear gradually within several hours after the injury and include dyspnea, tachypnea, chest pain, tachycardia, hypotension, crackles, and decreased or absent breath sounds over the affected area. Severe respiratory distress — with oppressive dyspnea, nasal flaring, use of accessory muscles, extreme anxiety, cyanosis, and diaphoresis — may develop at any time.
Severe pulmonary edema commonly causes frothy, blood-tinged pink sputum, which accompanies severe dyspnea, orthopnea, gasping, anxiety, cyanosis, diffuse crackles, a ventricular gallop, and cold, clammy skin. This life-threatening condition may also cause tachycardia, lethargy, cardiac arrhythmias, tachypnea, hypotension, and a thready pulse.
Hemoptysis is a common finding in this life-threatening disorder, although massive hemoptysis is infrequent. Typical initial symptoms are dyspnea and anginal or pleuritic chest pain. Other common clinical features include tachycardia, tachypnea, low-grade fever, and diaphoresis. Less commonly, splinting of the chest, leg edema, and — with a large embolus — cyanosis, syncope, and distended jugular veins may occur. Examination reveals decreased breath sounds, pleural friction rub, crackles, diffuse wheezing, dullness on percussion, and signs of circulatory collapse (weak, rapid pulse; hypotension), cerebral ischemia (transient loss of consciousness, convulsions), and hypoxemia (restlessness and, particularly in elderly patients, hemiplegia and other focal neurologic deficits).
Features of primary pulmonary hypertension generally develop late. Hemoptysis, exertional dyspnea, and fatigue are common. Angina-like pain usually occurs with exertion and may radiate to the neck but not to the arms. Other findings include arrhythmias, syncope, cough, and hoarseness.
Blood-streaked or blood-tinged sputum commonly occurs in pulmonary tuberculosis; massive hemoptysis may occur in advanced cavitary tuberculosis. Accompanying respiratory findings include a chronic productive cough, fine crackles after coughing, dyspnea, dullness to percussion, increased tactile fremitus, and possible amphoric breath sounds. The patient may also develop night sweats, malaise, fatigue, fever, anorexia, weight loss, and pleuritic chest pain.
Initially, silicosis causes a productive cough with mucopurulent sputum. Subsequently, the sputum becomes blood-streaked and, occasionally, massive hemoptysis may occur. Other findings include fine, end-inspiratory crackles at lung bases, exertional dyspnea, tachypnea, weight loss, fatigue, and weakness.
In 50% of patients with systemic lupus erythematosus (SLE), pleuritis and pneumonitis cause hemoptysis, cough, dyspnea, pleuritic chest pain, and crackles. Related findings are a butterfly rash in the acutephase, nondeforming joint pain and stiffness, photosensitivity, Raynaud’s phenomenon, convulsions or psychoses, anorexia with weight loss, and lymphadenopathy.
Lung or airway injury from bronchoscopy, laryngoscopy, mediastinoscopy, or lung biopsy can cause bleeding and hemoptysis.
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Blast lung injury.Although individuals with blast lung injury may not have obvious external chest injuries, they sometimes show other indications of internal damage, such as hemoptysis. Health care providers should evaluate survivors of explosive detonations for other classic signs and symptoms of a blast lung injury, such as chest pain, cyanosis, dyspnea, and wheezing. Treatment includes careful administration of fluids and oxygen to ensure tissue perfusion.
Bronchial adenoma.Bronchial adenoma is an insidious disorder that causes recurring hemoptysis in up to 30% of patients, along with a chronic cough and local wheezing.
Bronchiectasis.Inflamed bronchial surfaces and eroded bronchial blood vessels cause hemoptysis, which can vary from blood-tinged sputum to blood (in about 20% of cases). The patient's sputum may also be copious, foul-smelling, and purulent. He may exhibit a chronic cough, coarse crackles, clubbing (a late sign), a fever, weight loss, fatigue, weakness, malaise, and dyspnea on exertion.
Bronchitis (chronic).The first sign of chronic bronchitis is typically a productive cough that lasts at least 3 months. Eventually this leads to the production of blood-streaked sputum; massive hemorrhage is unusual. Other respiratory effects include dyspnea, prolonged expirations, wheezing, scattered rhonchi, accessory muscle use, barrel chest, tachypnea, and clubbing (a late sign).
Coagulation disorders.Such disorders as thrombocytopenia and disseminated intravascular coagulation can cause hemoptysis. Besides their specific related findings, these disorders may share such general signs as multisystem hemorrhaging (for example, GI bleeding or epistaxis) and purpuric lesions.
Lung abscess.In about 50% of patients, lung abscess produces blood-streaked sputum resulting from bronchial ulceration, necrosis, and granulation tissue. Common associated findings include a cough with large amounts of purulent, foul-smelling sputum; a fever with chills; diaphoresis; anorexia; weight loss; a headache; weakness; dyspnea; pleuritic or dull chest pain; and clubbing. Auscultation reveals tubular or cavernous breath sounds and crackles. Percussion reveals dullness on the affected side.
Lung cancer.Ulceration of the bronchus commonly causes recurring hemoptysis (an early sign), which can vary from blood-streaked sputum to blood. Related findings include a productive cough, dyspnea, a fever, anorexia, weight loss, wheezing, and chest pain (a late symptom).
Plague(Yersinia pestis).The pneumonic form of this acute bacterial infection can produce hemoptysis, a productive cough, chest pain, tachypnea, dyspnea, increasing respiratory distress, and cardiopulmonary insufficiency, along with the sudden onset of chills, a fever, a headache, and myalgia.
Pneumonia.In up to 50% of cases, Klebsiella pneumonia produces dark brown or red (currant jelly) sputum, which is so tenacious that the patient has difficulty expelling it from his mouth. This type of pneumonia begins abruptly with chills, a fever, dyspnea, a productive cough, and severe pleuritic chest pain. Associated findings may include cyanosis, prostration, tachycardia, decreased breath sounds, and crackles.
Pneumococcal pneumonia causes pinkish or rusty mucoid sputum. It begins with sudden, shaking chills; a rapidly rising temperature; and, in over 80% of cases, tachycardia and tachypnea. Within a few hours, the patient typically experiences a productive cough along with severe, stabbing, pleuritic pain. The agonizing chest pain leads to rapid, shallow, grunting respirations with splinting. Examination reveals respiratory distress with dyspnea and accessory muscle use, crackles, and dullness on percussion over the affected lung. Malaise, weakness, myalgia, and prostration accompany a high fever.
Pulmonary edema.Severe cardiogenic or noncardiogenic pulmonary edema commonly causes frothy, blood-tinged pink sputum, which accompanies severe dyspnea, orthopnea, gasping, anxiety, cyanosis, diffuse crackles, a ventricular gallop, and cold, clammy skin. This life-threatening condition may also cause tachycardia, lethargy, cardiac arrhythmias, tachypnea, hypotension, and a thready pulse.
Pulmonary embolism with infarction.Hemoptysis is a common finding in pulmonary embolism with infarction, a life-threatening disorder, although massive hemoptysis is infrequent. Typical initial symptoms are dyspnea and anginal or pleuritic chest pain. Other common clinical features include tachycardia, tachypnea, a low-grade fever, and diaphoresis. Less commonly, splinting of the chest, leg edema, and—with a large embolus—cyanosis, syncope, and jugular vein distention may occur. Examination reveals decreased breath sounds, a pleural friction rub, crackles, diffuse wheezing, dullness on percussion, and signs of circulatory collapse (a weak, rapid pulse; hypotension), cerebral ischemia (transient loss of consciousness, seizures), and hypoxemia (restlessness and, particularly in elderly patients, hemiplegia and other focal neurologic deficits).
Pulmonary hypertension (primary).With pulmonary hyperension, features generally develop late. Hemoptysis, exertional dyspnea, and fatigue are common. Angina-like pain usually occurs with exertion and may radiate to the neck but not to the arms. Other findings include arrhythmias, syncope, a cough, and hoarseness.
Pulmonary TB.Blood-streaked or blood-tinged sputum commonly occurs in pulmonary TB; massive hemoptysis may occur in advanced cavitary TB. Accompanying respiratory findings include a chronic productive cough, fine crackles after coughing, dyspnea, dullness on percussion, increased tactile fremitus, and possible amphoric breath sounds. The patient may also develop night sweats, malaise, fatigue, a fever, anorexia, weight loss, and pleuritic chest pain.
Systemic lupus erythematosus (SLE).In 50% of patients with SLE, pleuritis and pneumonitis cause hemoptysis, a cough, dyspnea, pleuritic chest pain, and crackles. Related findings are a butterfly rash in the acutephase, nondeforming joint pain and stiffness, photosensitivity, Raynaud's phenomenon, seizures or psychoses, anorexia with weight loss, and lymphadenopathy.
Tracheal trauma.Torn tracheal mucosa may cause hemoptysis, hoarseness, dysphagia, neck pain, airway occlusion, and respiratory distress.
Diagnostic tests.Lung or airway injury from bronchoscopy, laryngoscopy, mediastinoscopy, or lung biopsy can cause bleeding and hemoptysis.
Source: Nursing: Interpreting Signs and Symptoms, 2007
What do you think about the features of this website? Take our user survey and have your say:
Next articles:
Tools & Services:
Medical Articles:
Search Specialists by State and City
By using this site you agree to our Terms of Use. Information provided on this site is for informational purposes only; it is not intended as a substitute for advice from your own medical team. The information on this site is not to be used for diagnosing or treating any health concerns you may have - please contact your physician or health care professional for all your medical needs. Please see our Terms of Use.
Copyright © 2010 Health Grades Inc. All rights reserved. Last Update: 8 February, 2010 (23:01)
Clinical trials are important to the development of new lung cancer treatments. How can they help you?
When lung cancer spreads to the bone it can cause severe pain and weak bones. Learn how these bone complications can be treated and even prevented,...
New therapies are improving the survival rates for patients with lung cancer. How do these treatments work?
Lung Cancer, the leading cause of cancer death for both men and women in the US, will be diagnosed in over 169,000 people this year. Avoiding tobacco...
