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Pulmonary Arteriovenous Fistula

Pulmonary Arterio-Venous Fistula


Presentation

  • Presentation was in the form of a cerebrovascular accident (CVA). Clinical presentations and management strategies of PAVF with associated CAVM are broadly discussed along with a pertinent literature review.[ncbi.nlm.nih.gov]
Fever of Unknown Origin
  • After an intravenous antibiotic for fever of unknown origin was changed, her condition gradually improved. She was discharged with the help of a cane. Thirty-one months later, she suffered left hemiparesis.[ncbi.nlm.nih.gov]
Platypnea
  • We describe a case of a rare clinical disorder, platypnea-orthodeoxia syndrome. A 57-year-old man was admitted with progressive dyspnea.[ncbi.nlm.nih.gov]
  • The signs and symptoms of Pulmonary Arteriovenous Fistula include: Shortness of breath: Increased shortness of breath in upright position (platypnea), relieved by lying down Chest pain, cough that may contain blood in phlegm (hemoptysis) Migraine headaches[dovemed.com]
  • If the patient becomes significantly desaturated in the upright position, the patient also demonstrates platypnea, which is dyspnea in the upright position, although this symptom is seen only in advanced cases.[emedicine.medscape.com]
  • In view of the platypnea-orthodeoxia and family history of PAVMs associated with HHT, a provisional diagnosis of PAVMs associated with HHT was made.[ispub.com]
  • Approximately 1/3 of patients demonstrate orthodeoxia, but platypnea is seldom observed. Differential diagnosis Differential diagnoses include pulmonary artery aneurysms, pulmonary varices, bronchoceles and vascular tumors.[orpha.net]
Pulmonary Disorder
  • disorders. [6] Two reports published in Japan in the year 2011 and 2015, where the preoperative diagnosis on chest imaging was made as PAVM but histopathology was suggestive of an alternative diagnosis, in the above-mentioned cases lung cancer and lung[jacpjournal.org]
Vascular Disease
  • He had no history of smoking or thrombotic vascular diseases. In physical exam the patient had normal vital signs. He had left-side facial palsy and hemi paresis. He was dysarthric and complained of diplopia when looking to the right side.[advbiores.net]
  • Resumen Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) is an autosomal dominant vascular disease that can be associated with pulmonary arteriovenous fistulas.[repositorio.uchile.cl]
Lip Cyanosis
Hemianopsia
  • In a patient with left hemianopsia, computed tomography (CT) and magnetic resonance imaging revealed an intracranial space-occupying lesion in the right occipital region. A cerebral abscess was removed at craniotomy.[ncbi.nlm.nih.gov]

Workup

  • Platypnea-orthodeoxia syndrome is rare, and patients with this syndrome require an extensive workup to determine its cause.[ncbi.nlm.nih.gov]
  • It is beyond the scope of this text to discuss the entire workup and management of an HHT patient. 8 Our goal is to provide a basic guide to performing PAVF embolization with the current embolic technology available.[radiologykey.com]
  • A PaO2 of 90 mm Hg and a SO2 96.5% rule out any significant shunt, while a PaO2 85 mm Hg or a SO2 96% indicate a potential shunt fraction of 5%. ( 9 ) Significant shunt fraction measurement of 5% necessitate workup by Contrast Echocardiography (sensitivity[ispub.com]
Chest X-Ray Abnormal
  • Therefore, the presence of P-AVF in stroke patients who have normal physical findings and no chest x ray abnormalities cannot be excluded.[jnnp.bmj.com]
X-Ray Abnormal
  • Therefore, the presence of P-AVF in stroke patients who have normal physical findings and no chest x ray abnormalities cannot be excluded.[jnnp.bmj.com]
Arterial Oxygen Saturation Decreased
  • While breathing room air, arterial oxygen saturation decreased from 92% in a recumbent position to 83% in an upright position.[ncbi.nlm.nih.gov]
Eikenella
  • Streptococcus intermedius Kakar et al. (2003) 14) 18 M Cyanosis, clubbing, polycythemia Multiple Multiple No growth Kaido et al. (2011) 13) 69 F Asymptomatic Single Single No growth Recurrent brain abscess Caroli et al. (1992) 4) 35 M Asymptomatic Single Single Eikenella[jkns.or.kr]

Treatment

  • Large pulmonary arteriovenous fistula (PAVF) manifests as cyanosis and predisposes to serious complications of right-to-left shunt, and therefore necessitates early treatment.[ncbi.nlm.nih.gov]

Prognosis

  • With the increased blood flow in pregnancy such fistulas enlarge, occasionally giving rise to haemothorax, which generally has a poor prognosis.[ncbi.nlm.nih.gov]
  • Prognosis With appropriate management and interventions, prognosis is generally very good with many patients reaching their 9th and 10th decades of life. During pregnancy, however, there is a 1% maternal death rate.[orpha.net]
  • The prognosis of patients with HHT is not as good as for those without HHT. For patients without HHT, surgery to remove the abnormal vessels usually has good outcome and the condition is not likely to return.[mjdrdypu.org]
  • Treatment and prognosis Treatment options include: trans-catheter coil embolization surgery (historically treated with surgery) Once successfully treated (embolotherapy, surgical resection), prognosis is generally good for an individual lesion.[radiopaedia.org]

Etiology

  • The analysis of a concomitant occurrence of these abnormalities may be useful in elucidating the etiology of pulmonary arteriovenous fistula.[ncbi.nlm.nih.gov]
  • The etiology of this disease is usually congenital; however, they may be acquired in certain conditions, such as mitral stenosis, schistosomiasis, tuberculosis, trauma, and metastatic thyroid carcinoma.[mjdrdypu.org]

Epidemiology

  • (See "Risk factors and epidemiology of coronary heart disease in end-stage renal disease (dialysis)" .)[uptodate.com]
  • Lung India 33: 313-316 Zouboulis CC (1999) Epidemiology of Adamantiades-Behcet's disease. Ann Med Interne 150: 488-498. Erkan F (1999) Pulmonary involvement in Behcet disease. Curr Opin Pulm Med 5: 314-318.[omicsonline.org]
  • Summary Epidemiology Prevalence is estimated at around 1/ 2,600. There is a minor female predominance.[orpha.net]
  • Robert.1989.Age related clinical profile of HHT in an epidemiologically recruited population. Am J. Med Genet.32: 291-297 5.[ispub.com]
  • […] coils, particles, acrylates, or polymers introduced by a radiographically guided catheter, may be used in addition to neurosurgery or radiosurgery, but is rarely successful in isolation except in smaller AVMs. [15] Gamma knife may also be used. [16] Epidemiology[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • Grasp the full scope of the pathophysiology of CHD with well-organized, expert guidance. Quickly search the contents online, download images in JPG or PPT format, and view 70 echocardiogram videos at expertconsult.com.[books.google.com]
  • This implies that the pathophysiology of the arteriovenous malformations in these conditions is dilation of the normal capillary bed.[emedicine.medscape.com]
  • […] malformations [ edit ] In the lungs, pulmonary arteriovenous malformations have no symptoms in up to 29% of all cases. [5] Genetics [ edit ] Can occur due to autosomal dominant diseases, such as hereditary hemorrhagic telangiectasia. [ citation needed ] Pathophysiology[en.wikipedia.org]
  • PATHOPHYSIOLOGY In contrast to systemic arteriovenous malformation, PAVMs do not affect cardiac haemodynamics. 12, 13, 16 Cardiac output, cardiac index, pulmonary capillary wedge pressure, heart rate, blood pressure, and the electrocardiogram are usually[pmj.bmj.com]

Prevention

  • Therefore, we temporarily occluded the pulmonary artery with a balloon to prevent free thrombi from reaching the IVCF. Detection and treatment of PAVF are recommended in fertile young women.[ncbi.nlm.nih.gov]

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