Patients with a history of CHF may have hemoptysis developed solely on the basis of increased pulmonary venous pressure; this is particularly true in patients with mitral stenosis and associated pulmonary venous hypertension. Hemoptysis in patients with CHF is usually not massive, and patients typically produce blood-streaked or frothy pinkish red sputum. Pulmonary tuberculosis should always be considered in the differential diagnosis of hemoptysis, particularly in patients with long-standing active disease. Chronic smokers in whom hemoptysis develops should be suspected of harboring a bronchogenic carcinoma, and 50% of bronchial neoplasms are said to produce tracheobronchial bleeding at some time during their course. The bacterial pneumonias commonly produce blood-tinged sputum at some time in their course, although massive hemoptysis is unusual. Among hospitalized patients, pulmonary infarction is a more common cause of hemoptysis, and occasionally, pulmonary embolism not associated with actual infarction may produce mild tracheobronchial bleeding. If pleural pain accompanies hemoptysis, particularly in a sedentary or hypercoagulable patient, pulmonary embolism should be considered. Bronchiectasis, although a relatively uncommon disorder, is routinely accompanied by hemoptysis to such a degree that many patients are not alarmed by it.