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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

A 46-Year-Old Man With Dyspnea and Hemoptysis 3 Years Following Mitral Valve Repair*

Tobias J. Lange, MD; Andreas Luchner, MD; Dierk Endemann, MD; Michael Pfeifer, MD; Heinz F. Pitschner, MD; Christian Schulz, MD
Author and Funding Information

*From the Department of Internal Medicine II (Drs. Lange, Luchner, Endemann, Pfeifer, and Schulz), University of Regensburg, Regensburg, Germany; and the Department of Cardiology (Dr. Pitschner), Kerckhoff-Klinik GmbH, Bad Nauheim, Germany.

Correspondence to: Tobias J. Lange, MD, Department of Internal Medicine II / Division of Pneumology, Hospital of the University of Regensburg, Franz-Josef-Strauβ-Allee 11, 93053 Regensburg, Germany; e-mail: tobias.lange@klinik.uni-regensburg.de



Chest. 2007;132(2):704-707. doi:10.1378/chest.06-2953
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A 46-year-old man presented with recurrent hemoptysis, dyspnea on exertion (New York Heart Association II score), and episodes of cough. Symptoms first occurred 3 years ago, about 3 months after undergoing minimally invasive mitral valve repair for treatment of mitral regurgitation. The patient gave a history of pulmonary embolism, which was diagnosed on the basis of findings of a radionuclide lung scan that had been conducted shortly after the onset of symptoms. He denied having a fever, night sweats, weight loss, allergies, contact with pets, or exposure to toxic substances. He was a former cigarette smoker (40 pack-years). He was receiving therapy with a proton pump inhibitor because of gastroesophageal reflux disease and a history of a peptic ulcer. Anticoagulation had been discontinued several months before because of recurrent hemoptysis.

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