Multiple factors may trigger a nosebleed. Identifying the cause can be important in determining optimum management of the patient.


Increased blood pressure-related factors:

(1) increased arterial pressure (hypertension, coarctation of the aorta)

(2) increased venous pressure (congestive heart failure, superior vena cava syndrome, cor pulmonale)


Environmental factors:

(1) high pressure environment

(2) low pressure environment

(3) low humidity (dry)

(4) chemical irritants


Coagulation-related factors:

(1) thrombocytopenia

(2) coagulation factor defect (congenital or acquired)

(3) coumadin and/or heparin therapy

(4) aspirin or other anti-platelet medications

(5) acquired platelet dysfunction



(1) nosepicking

(2) blunt or penetrating trauma

(3) fracture (facial or nasal)

(4) foreign body

(5) surgery


Vascular disorders:

(1) vasculitis (Wegener's other)

(2) telangiectasia (hereditary hemorrhagic telangiectasia) or other vascular malformations

(3) scurvy (vascular fragility)

(4) corticosteroid therapy (vascular fragility)



(1) angioma

(2) fibroma

(3) carcinoma

(4) leukemia


Infection related - many types, including:

(1) upper respiratory viral infection

(2) measles

(3) infectious mononucleosis

(4) diphtheria

(5) typhoid fever

(6) Group A streptococcus

(7) pertussis

(8) fungal infection, including zygomycosis


Other causes:

(1) excessive coughing and/or sneezing

(2) rhinitis sicca

(3) exertion

(4) septal perforation

(5) allergic rhinitis

(6) pregnancy

(7) radiation therapy or exposure


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