Hemoptysis in Mitral Stenosis

Although the fact that mitral stenosis may cause hemoptysis long has been recognized, little emphasis apparently has been placed on its occurrence or prognostic significance. Indeed, there is a paucity of literature on this subject. Stewart,1in 1934, reported three cases with autopsy findings. He enumerated five situations in which blood appears in the sputum of patients suffering from mitral stenosis; namely, (1) pulmonary edema, (2) pulmonary infarction, (3) during the course of primary pneumonia, (4) paroxysmal pulmonary hemorrhage as described by Oppenheimer and Schwartz,2and (5) as a sign of "acute cardiac failure." More recently, Wolff and Levine3reported 50 cases of mitral stenosis with no selection of cases as to etiology of the hemoptysis. In reviewing hospital records of these cases, it became apparent that there is considerable lack of understanding of this problem, especially in the absence of congestive failure. In the investigation of