Diffuse Alveolar Hemorrhage due to Acute Mitral Regurgitation

ABSTRACT

Diffuse alveolar hemorrhage occurs from a variety of causes and mitral stenosis has been well known to cause hemoptysis. However, mitral regurgitation rarely can cause hemoptysis at presentation. A 38-year-old man who has been healthy was admitted to the hospital with massive hemoptysis. The patient underwent fiberoptic bronchoscopy which showed fresh blood throughout the bronchus of both lung and transbronchial biopsy showed chronic inflammation. All serologic and microbiologic markers were negative. On auscultation, grade 4 holosystolic murmur was incidentally heard at apex, the patient was examined by transthoracic 2-dimensional Doppler echocardiography which showed severe mitral regurgitation. Transesophageal echocardiography showed severe mitral regurgitation with A2 portion chordae rupture of anterior mitral leaflet. The patient was done with emergency mitral valve repair surgery and complete resolution of symptom and radiographic abnormalities thereafter.