A 49-Year-Old Man With Postcoital Hemoptysis

A 49-year-old man was seen in the pulmonary clinic for evaluation of postcoital hemoptysis. His medical history was significant for nonischemic cardiomyopathy and hypertension. He had red-yellow sputum with streaks of blood associated with dyspnea and wheezing for 5 years. He noted his symptoms occurred only with sexual intercourse while horizontal, but not while upright. He did not have any symptoms with other exertional activities, including heavy weight lifting. He did not have other symptoms. He had a remote history of less than 10 pack years of smoking. He had no personal or family history of pulmonary disease. He worked as a construction worker in the past, and currently as a driver. He had been incarcerated in the past but denied direct contact with TB. He was born in the United States, had always lived in the Northeastern region, and denied international travel. He had no constitutional symptoms or symptoms concerning for malignancy or autoimmune disease, including joint or skin complaints. His medications included aspirin, atorvastatin, carvedilol, furosemide, lisinopril, and spironolactone, and he endorsed adherence. He denied herbal or over-the-counter drugs use and denied illicit drug use.