Massive haemoptysis in mitral stenosis originates from
**Core Concept**
Massive haemoptysis in mitral stenosis is a life-threatening condition often attributed to the erosion of a bronchial artery aneurysm or the rupture of a pulmonary vein varix. The underlying pathophysiology involves increased pulmonary venous pressure and subsequent dilatation of the pulmonary veins, which may lead to rupture.
**Why the Correct Answer is Right**
The increased pulmonary venous pressure in mitral stenosis leads to congestion and dilatation of the pulmonary veins. Over time, this can cause the formation of varices, which are prone to rupture, resulting in massive haemoptysis. The erosion of a bronchial artery aneurysm can also occur due to the increased pressure and turbulence of blood flow in the bronchial arteries.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not relevant to the pathophysiology of massive haemoptysis in mitral stenosis.
* **Option B:** This option is incorrect as it does not accurately describe the underlying cause of massive haemoptysis in mitral stenosis.
* **Option D:** This option is incorrect as it is not a recognized cause of massive haemoptysis in mitral stenosis.
**Clinical Pearl / High-Yield Fact**
The presence of a new onset of massive haemoptysis in a patient with mitral stenosis warrants immediate investigation and intervention to prevent further bleeding and potential cardiac complications.
**Correct Answer:** C.