A window to a bleeding heart.

A 66-year-old man presented with dyspnoea and haemoptysis. Auscultation revealed a pansystolic murmur at the apex and right lung crepitations. Given a CRP of 89, white cell count 20.2 × 109/L, and the chest X-ray findings ( Panel A ), the patient was initially treated for a pneumonia. Computed tomographic pulmonary angiography showed no embolism but confirmed right lung ‘consolidation’ ( Panel B ). A diagnosis of alveolar haemorrhage (AH) was made and the patient commenced on …