Dyspnea and hemoptysis in a 26-year-old man

D. Luke Glancy, MD

A 26-year-old man was referred from another hospital, where he had presented with dyspnea and hemoptysis. His problems had begun in infancy. He had been the product of a full-term pregnancy and normal delivery. No cardiac murmur had been heard immediately after delivery, but a loud murmur was heard at his 6-week checkup, and his mother was told that he had a hole in his heart. Frequent and prolonged respiratory infections complicated infancy and early childhood. He underwent cardiac catheterization at 1 year of age. The physicians recommended an operation to close the hole in his heart, but his mother refused, at least in part because of a groin complication with the cardiac catheterization.