Hemoptysis is the expectoration of blood from a site below the larynx. It may be associated with sudden death under certain conditions.
Cause of death with hemoptysis:
(1) massive hemoptysis with exsanguination and shock
(2) hemoaspiration
(3) another cause, with hemoptysis a coincidental finding (pulmonary embolism, tuberculosis, fulminant sepsis, foreign body)
Nontraumatic massive hemoptysis can occur when there is a fistula between an artery/aorta and bronchus/trachea, which can occur in:
(1) aneurysm eroding into an airway
(2) a tumor in or adjacent to the lungs
(3) infection (abscess, tuberculosis, septic embolism, etc)
Conditions to rule out:
(1) penetrating trauma
(2) massive hematemesis
(3) pseudo-hemoptysis from bleeding in the nose, oral cavity or upper airway
