Pulmonary vein stenosis (PVS) is a rare but serious complication following atrial fibrillation ablation. We present a 41-year-old male with a history of paroxysmal atrial fibrillation and dilated cardiomyopathy who developed new-onset hemoptysis and ground-glass opacities (GGO) on imaging, months after his ablation procedure. Differential diagnoses included vasculitis, infection, and interstitial lung disease (ILD), all of which were ruled out. A dedicated pulmonary vein protocol computed tomography (CT) scan confirmed the diagnosis of high-grade stenosis of the left upper pulmonary vein. Due to the patient’s asymptomatic status post-hemoptysis, conservative management was pursued. This case underscores the importance of considering PVS in patients with similar presentations and highlights the role of interdisciplinary management in select cases.

JACC Case Reports Interim Editors-in-Chief 

Gilbert H. L. Tang, MD, MSc, MBA

CME Editor 

Kenneth A. Ellenbogen, MD

Author

Timir Paul, MBBS, PhD, FACC

 Important Dates

Date of Release: April 2, 2025 

Term of Approval/Date of CME/MOC Expiration: April 1, 2026