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Postgrad Med J 2002;78:191-197 doi:10.1136/pmj.78.918.191
  • Review

Pulmonary arteriovenous malformation

  1. I Khurshid,
  2. G H Downie
  1. Department of Pulmonary and Critical Care Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
  1. Correspondence and reprint requests to:
 Dr Imtiaz Khurshid, Department of Pulmonary and Critical Care Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA;
 khurshidi{at}mail.ecu.edu
  • Received 22 June 2001
  • Accepted 22 October 2001

Abstract

Pulmonary arteriovenous malformations (PAVM) are rare pulmonary vascular anomalies. Although most patients are asymptomatic, PAVMs can cause dyspnoea from right-to-left shunt. Because of paradoxical emboli, various central nervous system complications have been described including stroke and brain abscess. There is a strong association between PAVM and hereditary haemorrhagic telangiectasia. Chest radiography and contrast enhanced computed tomography are essential initial diagnostic tools but pulmonary angiography is the gold standard. Contrast echocardiography is useful for diagnosis and monitoring after treatment. Most patients should be treated. Therapeutic options include angiographic embolisation with metal coil or balloon occlusion and surgical excision.

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