Haemoptysis in chronic pulmonary vascular disease: a narrative review

Haemoptysis, the expectoration of blood from the lower airways, is a complication of several pulmonary vascular diseases (PVDs). The pathophysiology of haemoptysis in chronic PVDs is complex and varies depending on the underlying condition. Computed tomography pulmonary angiography remains the gold standard for localising the bleeding source and guiding interventional therapies. Management of haemoptysis in patients with chronic PVDs can range from oxygen supplementation to angiography-guided bronchial artery embolisation, depending on bleeding severity, anatomical features and specific features of the associated disease. Regardless of the management strategy, long-term follow-up is essential in these patients owing to the risk of recurrent bleeding. The aim of this review is to comprehensively explore the characteristics of haemoptysis in selected chronic PVDs, summarise current knowledge of the pathophysiology, and provide guidance on contemporary diagnostic and treatment strategies.