A 70-year-old woman was referred to the respiratory department with a 6-month history of dry cough and intermittent minor haemoptyis. This was associated with a sensation of chest discomfort and some shortness of breath on moderate exertion with no orthopnoea or paroxysmal nocturnal dyspnoea. She had a background of coronary artery disease treated by stenting two years previously. She also had a hiatus hernia, type 2 diabetes and cervical spondylosis.