Alashqar Ahmad, Alashqar Mohammad, Daraghmeh Ahmad, Dalbah Hala A I, Abu Kamesh Mohammed I, Giacaman Yazan, Hajj-Qasem Salma
Department of Medicine, Alexandria University, Alexandria, Egypt.
Department of Medicine, An-Najah National University, PO Box 7, Nablus, West Bank, Palestine.
Oxf Med Case Reports. 2025 Jul 27;2025(7):omaf107. doi: 10.1093/omcr/omaf107. eCollection 2025 Jul.
Hemoptysis is the expectoration of blood originating from the lower respiratory tract and has a wide differential diagnosis, ranging from benign conditions to life-threatening diseases that include pulmonary embolism, severe infections, and aortic dissection. We present a 53-year-old male with a history of hypertension, COPD, and smoking, presenting to the emergency department with a two-day history of hemoptysis. In spite of the absence of classical symptoms such as chest pain, his chest X-ray showed mediastinal widening, and further imaging was performed with contrast-enhanced CT angiography. The CT scan confirmed a Stanford Type B aortic dissection. After multidisciplinary review, medical management was decided upon with antihypertensive medications and tranexamic acid. The patient remained hemodynamically stable and was transferred for further management. This case indicates the inclusion of aortic dissection in the differential diagnosis of hemoptysis, even without classic symptoms.
咯血是指源自下呼吸道的血液咳出，其鉴别诊断范围广泛，从良性情况到危及生命的疾病，包括肺栓塞、严重感染和主动脉夹层。我们报告一名53岁男性，有高血压、慢性阻塞性肺疾病（COPD）和吸烟史，因咯血两天就诊于急诊科。尽管没有胸痛等典型症状，但其胸部X线显示纵隔增宽，随后进行了增强CT血管造影进一步检查。CT扫描证实为斯坦福B型主动脉夹层。经过多学科会诊，决定采用抗高血压药物和氨甲环酸进行药物治疗。患者血流动力学保持稳定，并被转至其他科室进一步治疗。该病例表明，即使没有典型症状，主动脉夹层也应纳入咯血的鉴别诊断之中。
