A 54 yo male from the Orient presents with his second episode of hemoptysis since arriving in the US. Three months ago he had a positive ppd test but stopped taking his medications after a month. In general, when a patient has hemoptysis, which of the following blood vessels is the source of bleeding?
A
B
C
D
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The bronchial arteries are the major supply of high-pressure oxygenated blood to the supporting structures of the lung, including the pulmonary arteries, yet they are responsible for only 1% of the lung blood flow overall.
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Bronchial artery anatomy is variable, most commonly classified according to Cauldwell classification. A classic pattern of two left and a one right main bronchial arteries is found in ~70% of patients. The bronchial vessels supply about 5% of blood to the lungs.
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These bronchial arteries are under high pressure, unlike the low-pressure pulmonary vessels. Massive hemoptysis is generally defined as expectoration of greater than 300–600 mL of blood in 24 hours. The source of hemoptysis in 90% of cases that require intervention is the bronchial arteries.
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Pulmonary arteries are usually the cause when there is damage during arterial catheterization, tumor or erosion or trauma.