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.