Severe Rheumatic Mitral Stenosis Presenting as Recurrent Hemoptysis in a Young Female With Respiratory Symptoms.

Rheumatic mitral stenosis remains a significant cause of cardiovascular morbidity in young adults worldwide, yet its diagnosis can be challenging when clinical presentation overlaps with concurrent infections. We present a case of a woman in her 30s who presented with dyspnoea, fever, and haemoptysis, initially attributed to community-acquired pneumonia with concurrent viral and bacterial infection. She received appropriate treatment and was discharged; however, her symptoms persisted, and she developed alveolar haemorrhage, prompting further investigations, which ultimately revealed severe mitral stenosis secondary to rheumatic heart disease. This case underscores the diagnostic complexity of mitral stenosis in the setting of overlapping pulmonary infections and highlights the critical importance of maintaining a broad differential diagnosis and pursuing thorough cardiac assessment in patients with unexplained haemoptysis.