Massive haemoptysis in mitral stenosis originates from

Ans. a (Pulmonary veins). (Ref. Harrison, Principles of Medicine, 18th ed./Chapter 237.)# Haemoptysis in mitral stenosis results from rupture of pulmonary-bronchial venous connections secondary to pulmonary venous hypertension.# It occurs most frequently in patients who have elevated LA pressure without marked increase in pulmonary venous resistance and is almost never fatal.# But as severity of MS pogresses, PVR increases or when TR/TS develops, episodes of edema and hemoptysis decrease in frequency and severity.# Recurrent pulmonary emboli, sometimes with infarction, are an important cause of morbidity and mortality rates late in the course of MS. Pulmonary infections, i.e., bronchitis, bronchopneumonia, and lobar pneumonia, commonly complicate untreated MS, especially during the winter months.# In general, the bronchial artery is the source of hemoptysis in about 90% of cases, and in remain ing 10% (who don't respond to BAE by polyvinyl alcohol), the source may be Rassmussen's aneurysm (arising from pulmonary arteries)# BAE is a life-saving interventional procedure for massive hemoptysis.