Simple pulmonary arteriovenous malformation (PAVM)

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Post-lithotripsy desaturation and tachycardia.

Patient Data

Age: 65 years
Gender: Female

Patent and well opacified pulmonary trunk and main pulmonary arteries. Lobar arteries as well as their segmental branches are also patent and well opacified. Incidental finding of a small pulmonary arteriovenous malformation (PAVM) in the lingula. Heart is not enlarged. No pleural/pericardial effusion,  pneumothorax or pneumomediastinum is noted. Multiple small sub centimeter mediastinal and bilateral axillary lymph nodes are seen. Mild degenerative changes are seen in the dorsal spine.

Case Discussion

  • Incidental finding of a small pulmonary arteriovenous malformation which is of simple type (single feeding artery with a single draining vein). The feeding artery measures 2.5 mm in diameter. The patient has no clinical features of paradoxical embolism.

  • Pulmonary arteriovenous malformation (PAVM) is an abnormal direct capillary free communication between the pulmonary arteries and veins which results in a right-to-left extra-cardiac intrapulmonary shunt. They are most commonly seen in association with hereditary hemorrhagic telangiectasia (HHT) and sporadic cases are uncommon 1.

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