Life-Threatening Hemoptysis in Mitral Stenosis

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Abstract
A 32-year-old patient with mitral stenosis and a long history of recurrent hemoptysis was hospitalized because of life-threatening pulmonary bleeding, and required transfusion of 34 units of whole blood. Emergency insertion of a Starr-Edwards ball valve prosthesis resulted in prompt cessation of hemorrhage, and at nine months follow-up, the hemorrhage has not recurred. Review of 14 cases of patients with massive hemoptysis associated with mitral stenosis (seven operated upon and seven not operated upon) reveals that five of the conservatively treated patients died, in contrast to only two who died in the group operated upon. Mitral valve surgery appears to be consistently associated with rapid and sustained cessation of hemoptysis. Therefore, surgery should be considered in hemoptysis due to mitral stenosis, particularly when the danger of asphyxiation exists.

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