Epistaxis history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Liudvikas Jagminas, M.D., FACEP [2] , Amir Behzad Bagheri, M.D.

The hallmark of epistaxis is nosebleed. History of nose-picking, facial trauma, hypertension and coagulopathy may be found. The less common symptoms of epistaxis include fainting, dizziness, and hypovolemic shock.

Patients with epistaxis may have a positive history of:^[1]

• Trauma
• Allergy symptoms
• Bleeding in other areas
• Common cold
• Foreign bodies
• Nose-picking
• Neoplasia
• Coagulopathy
• History of nasal irritation
• Previous epistaxis
• Rhinorrhea
• Sinus/tooth pain

• Some factors may worsen the nose bleeding or act as triggers such as: nose blowing habit, excessive coughing, which may happen in chronic obstructive pulmonary disease, straining, as happens in case ofconstipation and benign prostatic hyperplasia, and lifting heavy objects.^[2]
• Refractory nosebleed or profuse bleeding may be suggestive of posterior epistaxis.

• The hallmark of epistaxis is nose bleeding.

• Heavy epistaxis can cause hypovolemia. As a result, dizziness and fainting can be symptoms of epistaxis.^[3]

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