A case of dyspnea: respiratory failure due to pulmonary arteriovenous malformation

Pulmonary arteriovenous malformations (PAVMs) are abnormal communications between pulmonary arteries and veins. The clinical features suggestive of PAVMs are stigmata of right-to-left shunting (dyspnea, hypoxemia, cyanosis, cerebral embolism, brain abscess), unexplained hemoptysis, or hemothorax. We present a case of a young man who presented to the Emergency Department complaining of dyspnea, polycythemia, and persistent hypoxemia. Angio-computed tomographic scan of the chest detected multiple PAVMs. PAVMs are uncommon in the general population, but they represent an important consideration in the differential diagnosis of common pulmonary problems, including hypoxemia, pulmonary nodules, and hemoptysis.